Acceptability of Human Papillomavirus Self-Sampling Among a National Sample of Women in the United States

Abstract

As human papillomavirus (HPV) self-sampling continues to emerge as a potential cervical cancer screening strategy in the United States, it is necessary to examine women's acceptability of this screening approach. Furthermore, since several HPV self-sampling devices exist, it is important to determine if women's preferences differ by device type. We conducted an online survey in Fall 2017 with a national sample of women ( n = 605) ages 21–65 years (the recommended age range for cervical cancer screening). Multivariable linear regression identified correlates of women's willingness to use an HPV self-sample at home. We used repeated measures analysis of variance to determine if preferences differed across four self-sampling devices: Evalyn ® Brush (Device A), HerSwab ® (Device B), Catch-All ® Swab (Device C), and Qvintip ® (Device D). Most women were willing to use an HPV self-sample at home (mean = 4.03 [possible range: 1–5], standard deviation = 1.09, 72.7% indicated “probably willing” or “definitely willing”). The most common concerns about self-sampling were related to test accuracy (53.1%) and obtaining the sample incorrectly (51.1%). Women were more willing to use an HPV self-sample at home if they reported greater perceived severity of cervical cancer ( β = 0.16), reported an annual income less than $50,000 ( β = 0.13), or were a former smoker ( β = 0.11). Women were more willing to use Device A (mean = 3.72, 67.6% indicated “agree” or “strongly agree”), Device C (mean = 3.86, 73.9% indicated “agree” or “strongly agree”), and Device D (mean = 3.81, 72.1% indicated “agree” or “strongly agree”) than Device B (mean = 3.36, 49.4% indicated “agree” or “strongly agree”; all p < 0.05). Acceptability of HPV self-sampling as a cervical cancer screening strategy is generally high among women. Future efforts should consider the potential impact that device type may have on women's use of an HPV self-sample at home.

Cervical Cancer Screening Postpandemic: Self-Sampling Opportunities to Accelerate the Elimination of Cervical Cancer

“… 55 , 56 , 113 In a recent study in the US, women were more willing to use devices that closely resemble a basic swab than three other swab- and brush-based devices. 51 Interestingly, this study also found women’s willingness to use a specific brush device varied by sexual orientation: sexual minority women were more willing to use the HerSwab device than heterosexual women.…”

“… 82 , 135 On the other hand, nearly 20% of women indicate that they do not have any concerns about using a self-sample. 51 To address women’s concerns, positive feedback from large-scale studies should be presented through public-awareness campaigns, including data showing that most women are able to successfully obtain an adequate sample. 51 , 96 , 102 , 115 …”

“… 51 To address women’s concerns, positive feedback from large-scale studies should be presented through public-awareness campaigns, including data showing that most women are able to successfully obtain an adequate sample. 51 , 96 , 102 , 115 …”

Special ambulatory gynecologic considerations in the era of coronavirus disease 2019 (COVID-19) and implications for future practice

“… 61 The USPSTF also endorses primary HPV testing–only strategies. 62 The pandemic may thus provide an opportunity to expand use of patient-collected HPV self-swabs which have been reported to be acceptable to patients and noninferior to physician collection, 63 , 64 , 65 potentially leading to increased screening of underrepresented populations such as transgender or gender nonconforming patients. 66 , 68 , 67 For immunocompromised patients requiring more urgent follow-up but who are at high risk if they acquire COVID-19, providers can consider integrating self-collection kits that are able to be returned by mail into current practice.…”

Self-Sampling as a Plausible Alternative to Screen Cervical Cancer Precursor Lesions in a Population with Low Adherence to Screening: A Systematic Review

“…Consequently, a cheap, practical, and highly sensitive solution with high specificity is always welcomed by the health authorities. In this context, the self-collection of vaginal cells delegates the responsibility to the women themselves to minimize the negative impact that any religious and cultural constraints may cause, and indecisive women can be encouraged to participate in screening programs [5][6][7]. The methodological premise of self-sampling is simple, since the material is sent to a reference laboratory that will evaluate the presence of HPV.…”