Recorded presentation

Kathleen L. Irwin, MD, MPH¹, Hilda Shepeard, MBA², Rheta Barnes, MSN, MPH³, Carol S. Freeman, BA⁴, Crystal M. Freeman, PhD, MPH⁵, Katherine Hsu, MD⁶, Alison Friedman, MPH², Sureyya Hornston, PhD², Danuta Kasprzyk, PhD⁷, and Daniel E. Montaño, PhD⁸. (1) Health Services Research and Evaluation Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, mailstop E-80, Atlanta, GA 30333, 404-639-8979, kirwin@cdc.gov, (2) Division of STD Prevention, CDC, Training and Health Communications Branch, 1600 Clifton Road, mailstop E-02, Atlanta, GA 30333, (3) Division of STD Prevention, MS-E02, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta, GA 30329, (4) ORC Macro, 11785 Beltsville Drive, Calverton, MD 20705, (5) Battelle, Centers for Public Health Research and Evaluation, 4500 Sand Point Way NE, Suite 100, Seattle, WA 98105-3949, (6) Section of Pediatric Infectious Diseases, Boston University Medical Center, Finland Labs, 5th Floor, 774 Albany Street, Boston, MA 02118-2393, (7) Battelle Memorial Institute, Center for Public Health Research and Evaluation, 4500 Sand Poin Way NE, PO Box 5395, Seattle, WA 98105, (8) Centers for Public Health Research and Evaluation, Battelle Memorial Institute, 4500 Sand Point Way N. E, P. O. Box 5395, Seattle, WA 98105-0395

Background: Information about genital HPV infection, anogenital neoplasia, and anogenital warts has evolved rapidly over the last decade. Several U.S. organizations have recently issued guidelines about using HPV tests for cervical cancer screening and abnormal cytology management. This new information and guidelines may have influenced clinician knowledge, attitudes, and practices. We therefore reviewed information on clinician knowledge, attitudes, and practices about genital HPV infection, cervical dysplasia, and anogenital warts and existing clinical information resources.

Methods: We reviewed peer-reviewed literature since 1995, conducted interviews of >80 primary care and specialty physicians and mid-level providers, and analyzed content of >50 print and website clinical sources.

Results: Most clinicians were aware that HPV infection is common, chronic, and often asymptomatic. Although many clinicians understood differences between high- and low-risk HPV types, some advised immediate Pap testing to wart patients. Many clinicians found that patients’ psychosocial concerns made discussing HPV complex, uncomfortable, and time-consuming. Many clinicians were uncertain about new HPV test indications, the impact of treating HPV-related disease on transmission risk, and effective prevention methods. Clinical information sources included vague, inconsistent information about HPV and HPV testing indications; few addressed counseling and partner management issues, especially for culturally- and linguistically-diverse patients.

Conclusions: These data informed design of a nationally-representative mail survey of >7000 clinicians about HPV-related knowledge, attitudes and practices; survey findings available by October 2004 will be presented. Using interview and survey data, CDC and other organizations will develop accurate, up-to-date clinician training materials, decision support tools, and patient educational materials.

Learning Objectives: The participants will describe

• typical knowledge, attitudes, and practices about HPV among U.S. clinicians
• characteristics of print and web-based clinical information sources about HPV
• gaps in knowledge and practice that need to be addressed in clinical training curricula, clinical decision support tools,and patient education materials.

Keywords: Cancer Screening, STD

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: The presentation will describe off-label use of FDA-approved HPV DNA tests reported by U.S. health care providers in a national survey.
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation