Acceptability of self-sampling human papillomavirus test for cervical cancer screening in Japan: A questionnaire survey in the ACCESS trial

Abstract

Purpose In terms of medical policy for cervical cancer prevention, Japan lags far behind other industrialized countries. We initiated a randomized controlled trial to evaluate the self-sampling human papillomavirus (HPV) test as a tool to raise screening uptake and detection of pre-cancer. This study was conducted to explore the acceptability and preference of self-sampling using a subset of the data from this trial. Methods A pre-invitation letter was sent to eligible women, aged 30−59 years who had not undergone cervical cancer screening for three or more years. After excluding those who declined to participate in this trial, the remaining women were assigned to the self-sampling and control groups. A second invitation letter was sent to the former group, and those wanting to undergo the self-sampling test ordered the kit. A self-sampling HPV kit, consent form, and a self-administered questionnaire were sent to participants who ordered the test. Results Of the 7,340 participants in the self-sampling group, 1,196 (16.3%) administered the test, and 1,192 (99.7%) answered the questionnaire. Acceptability of the test was favorable; 75.3−81.3% of participants agreed with positive impressions (easy, convenient, and clarity of instruction), and 65.1−77.8% disagreed with negative impressions (painful, uncomfortable, and embarrassing). However, only 21.2% were confident in their sampling procedure. Willingness to undergo screening with a self-collected sample was significantly higher than that with a doctor-collected sample (89.3% vs. 49.1%; p<0.001). Willingness to undergo screening with a doctor-collected sample was inversely associated with age and duration without screening (both p<0.001), but that with a self-collected sample was not associated. Conclusions Among women who used the self-sampling HPV test, high acceptability was confirmed, while concerns about self-sampling procedures remained. Screening with a self-collected sample was preferred over a doctor-collected sample and the former might alleviate disparities in screening rates.

The efficacy of the clinic-based HPV self-sampling approach among HIV- infected rural women in Uganda.

“…Long distance from the access point at the HIV clinic and the CLP location is a significant barrier to HPV self-sampling. Our findings are like previous studies which have assessed distance as a blockage to HPV self-sampling among HIV-infected women [21,33,37,40,47,49,50]. Therefore, there is a need to improve the CLP program which would create demand for HPV self-sampling in preferred places for HPV self-sampling among HIV-infected women.…”

Evaluation of a novel vaginal cells self‐sampling device for human papillomavirus testing in cervical cancer screening: A clinical trial assessing reliability and acceptability

“…Recent studies have consistently demonstrated the favorable reception of vaginal self‐sampling tools as a screening method among women. 33 , 34 , 35 Women frequently cited ease of use, lack of shame, privacy, and comfort as reasons for choosing self‐sampling over physician sampling. Our findings align with previous research conducted across various populations, which also highlighted women's acceptance, experience, comfort, and preference.…”

The levels of women’s awareness, experience, acceptability and preference for Vaginal Human Papillomavirus (HPV) self-sampling in three provinces of China: a cross-sectional study

“…Adequate knowledge and positive attitudes are the basis of successful practices [12], and it is crucial to understand the knowledge and attitudes of people from different cultural backgrounds toward HPV self-sampling. In addition, several studies have shown that sociodemographic characteristics such as age, ethnicity, religion, education, economic income, and the duration of cervical cancer screening greatly influence the feasibility and acceptability of HPV self-sampling [13][14][15]. Jiangsu, Zhejiang, and Shanghai, which are more developed regions in China in terms of economic, technological, and medical development, provide favorable external conditions for HPV self-sampling.…”