Provider beliefs in effectiveness and recommendations for primary HPV testing in three healthcare systems.

In 2018, the U.S. Preventive Services Task Force endorsed primary human papillomavirus testing (pHPV) for cervical cancer screening. We aimed to describe provider's beliefs about pHPV testing effectiveness and which screening approach they regularly recommend. We invited providers who performed ≥10 cervical cancer screens in 2019 in three healthcare systems that had not adopted pHPV testing: Kaiser Permanente Washington, Mass General Brigham, and Parkland Health; 53.7% (501/933) completed the survey between October and December 2020. Response distributions varied across modalities (p < .001) with cytology alone or co-testing being more often viewed as somewhat/very effective for 30-65-year-olds compared to pHPV (cytology alone 94.1%, co-testing 96.1%, pHPV 66.0%). In 21-29-year-olds, the pattern was similar (cytology alone 92.2%, 64.7% co-testing, 50.8% pHPV). Most providers were either incorrect or unsure of the guideline-recommended screening interval for pHPV. Educational efforts are needed about the relative effectiveness and recommended use of pHPV to promote guideline-concordant care.