Self‐collection of samples for HPV testing to increase participation in cervical cancer screening by immigrant women: An integrative review

Abstract

Objective To examine methods and results of studies assessing self‐collection of cervico‐vaginal samples for human papillomavirus (HPV) testing by immigrant women for insights into how future research using this method with unique subpopulations of women may improve the rates of cervical cancer screening (CCS) compared to current strategies. Data Sources Four electronic databases were systematically searched through March 2020, with no limits applied. A manual review of reference lists was also completed. Study Selection The search resulted in 63 articles. After removal of duplicates, 36 were reviewed against inclusion criteria. A manual review of reference lists yielded two additional studies. The final sample included 15 relevant publications representing 13 unique empirical studies. Data Extraction Data related to study methodology and empirical results were extracted into table form. Data Synthesis The methods of the studies were summarized and synthesized, including diversity of participants, community engagement, including collaboration with public health nurses or community health workers. In addition, methods and findings related to the educational components of the studies, and empirical findings related to various cultural groups, were described. Conclusion To reduce health disparities in CCS, researchers should focus on diverse groups, such as immigrant women, to understand important individual and group‐specific factors that may influence screening, including whether self‐collection of samples for HPV testing along with appropriate education and support for follow‐up will address these factors.

Acceptance of Self-Sampling by Women Not Regularly Participating in Cervical Cancer Screening in Areas with Low Medical Density: A Qualitative Study within the French CapU4 Trial

“…Muslim culture was cited and rightly associated by our participants with a reduced likelihood of being up to date with cervical cancer screening [ 43 ]. Both interviews and focus groups validated the idea of accompanying certain immigrant women in screening education and offering appropriate support in follow-up to reduce disparities [ 44 ]. Level of education strongly influences the use of screening, with more highly educated women more likely to undergo it regularly [ 45 ].…”

What do South Asian immigrant women know about HPV, cervical cancer and its early detection: A cross-sectional Australian study

“…Results suggest that less than half of the women had heard of the screening test in their home countries (48.6%). Previous studies reported that lack of concept of screening in home countries may be one of the reasons for lower knowledge and uptake of screening in immigrants ( Vahabi and Lofters, 2016 , Mullins et al., 2014 , Elmore et al., 2020 ). Thus a need for including cervical screening education and support among other health care services for newly arriving immigrants can't be overlooked.…”

“…Given the cultural background, modesty and reluctance towards cervical screening, self-sampling could potentially increase South Asian women's screening uptake ( Marlow et al., 2015 , Vahabi and Lofters, 2016 , Mullins et al., 2014 ). However, self-sampling directions need to be clear and easy to follow, taking into account the potential for language barriers and reservations women may hold against this method such as inability to perform test accurately or belief that it could lead to self harm ( Elmore et al., 2020 , Howard et al., 2009 ).…”

Health Inequity in Cervical Cancer Control Among Refugee Women in the United States by Country of Origin

“…14,15 We can do this by assessing our migrant and refugee patients' need for culturally tailored education around prevention and screening for cervical cancer, and by continuing to research novel ways of increasing screening for this vulnerable population. 16,17 Although this brief report focuses only on cervical cancer control, it may also serve as a bellwether for increased awareness about disparities related to other cancers and noncommunicable diseases for refugee populations.…”