Women's perspectives on human papillomavirus self‐sampling in the context of the <scp>UK</scp> cervical screening programme

Williams, Denitza; Davies, Malcolm; Fiander, Alison; Farewell, Daniel; Hillier, Sharon; Brain, Katherine Emma

doi:10.1111/hex.12544

Cited by 25 publications

(41 citation statements)

References 32 publications

(37 reference statements)

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“…For some women, home may not be a safe or a private environment. Furthermore, research into women’s perspectives of HPV self‐testing has identified concerns including low confidence in the ability to self‐sample, worries that samples may be lost or contaminated in the post, that HPV tests may be inferior to cytology tests, and fears about a lack of professional input and low confidence in the test result . Here, it is possible that uncertainties around the HPV SSK per se exerted a greater influence on women’s screening decisions than the general process of how self‐sampling is delivered as covered by the DCE.…”

Section: Discussionmentioning

confidence: 99%

“…The inconvenience of attending, coupled with the embarrassment of a gynaecological examination, could potentially be overcome by the use of a HPV SSK. Some women, however, have concerns around their competence to perform a home test . To account for these aspects, we included the attribute ‘Location of the test’ with levels ‘GP surgery/clinic’ and ‘Home’.…”

Section: Methodsmentioning

confidence: 99%

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Preferences for interventions designed to increase cervical screening uptake in non‐attending young women: How findings from a discrete choice experiment compare with observed behaviours in a trial

Campbell

Gray

Watson

et al. 2019

Health Expectations

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Background: Young women's attendance at cervical screening in the UK is continuing to fall, and the incidence of invasive cervical cancer is rising. Objectives:We assessed the preferences of non-attending young women for alternative ways of delivering cervical screening.Design: Postal discrete choice experiment (DCE) conducted during the STRATEGIC study of interventions for increasing cervical screening uptake. Attributes included action required to arrange a test, location of the test, availability of a nurse navigator and cost to the National Health Service.Setting and participants: Non-attending young women in two UK regions. Main outcome measures:Responses were analysed using a mixed multinomial logit model. A predictive analysis identified the most preferable strategy compared to current screening. Preferences from the DCE were compared with observed behaviours during the STRATEGIC trial. Results:The DCE response rate was 5.5% (222/4000), and 94% of respondents agreed screening is important. Preference heterogeneity existed around attributes with strong evidence for test location. Relative to current screening, unsolicited selfsampling kits for home use appeared most preferable. The STRATEGIC trial showed this same intervention to be most effective although many women who received it and were screened, attended for conventional cytology instead. Conclusions:The DCE and trial identified the unsolicited self-sampling kit as the most preferred/effective intervention. The DCE suggested that the decision of some | 203 CAMPBELL Et AL.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Preferences for interventions designed to increase cervical screening uptake in non‐attending young women: How findings from a discrete choice experiment compare with observed behaviours in a trial

Campbell

Gray

Watson

et al. 2019

Health Expectations

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“…Despite generally high acceptability of selfcollection, some women expressed concerns of sampling accuracy and a lack of confidence in collecting the sample correctly 30 . Perceptions of low self-efficacy to perform the test can negatively impact women's attitudes towards using selfsampling 31 , underscoring the need for health education as part of an implementation plan. Additional studies conducted in Australia 28 , Denmark 26 , Sweden 32 , and Norway 33 largely recommend the use of self-collected hpv screening to increase participation in screening among under-screened populations.…”

Section: Using Hpv Self-collection To Reach Under-screened Womenmentioning

confidence: 99%

Implementation Considerations Using HPV Self-Collection to Reach Women Under-Screened for Cervical Cancer in High-Income Settings

et al. 2018

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The success of cytology (Pap screening) programs is undeniable and has drastically reduced cervical cancer rates in high-income settings where it has been implemented 1 . However, cytology for primary cervical cancer screening has a number of limitations including poor sensitivity, a taxing demand on human and operational infrastructure, high health system costs, and limited uptake rates, leading researchers and policy-makers to question whether further gains in public health are possible using this approach 2 . Persistent infection with high-risk genotypes of human papillomavirus (hpv) is well established as the necessary cause for development of cervical cancer 3 . Research has shown a 30% improvement in sensitivity in detecting high-grade lesions, cervical squamous intraepithelial neoplasia (cin) grade 2 or greater (cin2+), can be achieved with high-risk hpv dna testing compared with cytology 4 . A negative hpv test confers two-fold greater reassurance against the development of cervical cancer over three years compared with a negative cytology test 2,5 . The Netherlands has recently transitioned from cytology to hpv testing for primary cervical cancer screening in their National program. Many organized screening programs intend to implement primary hpv screening 6-9 , including Australia, which will begin implementation in December 2017.A consistent barrier to cytology-based cervical cancer screening is non-attendance, which can be addressed through hpv testing using self-collected samples. Primary cervical cancer screening with hpv dna testing allows for the opportunity of self-collected samples, which is not possible with cytology. In hpv self-collection the sample is obtained vaginally by the woman herself, using a device such as a swab or brush. The swab is subsequently tested for high-risk strains of hpv in a laboratory. With this approach to screening, programs can mail self-collection kits directly to women who are overdue for screening as an alternative to a clinic-based visit. Self-collected cervical samples receiving hpv testing show comparable cin2+ sensitivity compared with clinician-collected samples tested with cytology and with hpv 10-12 . Self-collection has proven to be highly acceptable among women 13 .Huma n papillomav ir us self-collection has t he potential to overcome many of the personal and systemlevel barriers to screening that exist for cytology or other clinic-based screening methods. Some women, particularly those who have experienced abuse 14 or are otherwise marginalized, may find self-sampling preferable because of such things as cultural/religious embarrassment or discomfort associated with a pelvic exam 13,[15][16][17] . Time, transportation, inconvenient clinic hours, or not having a regular practitioner are also relevant factors associated with under-screening that can be mitigated through hpv self-collection using mailed samples 13,16,17 . However, there are psychosocial barriers to hpv screening, including women's lack of awareness and fears around hpv and cervical cancer...

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“…Williams et al [28] report that the lack of knowledge related to HPV and self-sampling is a barrier to wanting the test, and Crofts et al [29] and Penaranda et al [30] argue that the number of women who prefer self-sampling increased by educational interventions on CC and self-sampling. Moreover, it is eminently important to explain about self-sampling safely, efficacy, how to use kits, the diagnosis accuracy, and follow up system according to women's life events, with face to face instructing by clinicians, nurses and midwives as well as training from instruction booklets, DVDs, and explanatory leaflets with self-sampling kit for sustainable self-sampling.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of CC excepted of carcinoma insitu (CIS) in 25-29 year old Japanese women was 3.0 (per 100,000 people) in 2016 [3],and the mortality of the women was 0.3 (per 100,000 people) in 2017 [4]. However, the rate of people attending CC screenings, a preventive measure, was 42.4% in 25-69 year old and 26.5% in [20][21][22][23][24][25][26][27][28][29] year old Japanese women in 2016, being markedly lower than those in Western countries, and similar to middle income country rates [5].…”

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confidence: 99%

Awareness of Young Japanese Women on HPV Self-Sampling Trial using Opt-in Method

Tada¹,

Ito²,

Nagai³

et al. 2019

Preprint

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BackgroundThe rate of young Japanese women attending Cervical Cancer screenings is still low. There is a lack of studies that discussed awareness, preference, and anxiety of women to HPV self-sampling. The aim was to clarify the awareness of young women who want and do not want HPV self-sampling toward improvement the rate of attending Cervical Cancer screenings.Methods We carried out the observation study by self-administered questionnaires about the awareness of HPV self-sampling with the trial in a city, in Hokkaido, Japan. The subjects were selected at random to 25-29 years old women (837 persons) residing in a city. We compared their awareness between want and do not want self-sampling. For data analysis, statistical analysis software SPSS for Windows Ver.21 was used setting the significance level at below 5%.ResultsYoung women in this study who firstly responded wanting practice of self-sampling were 9.8%, and not wanting in were 90.2%. The reasons of young women that want self-sampling were “Free self-sampling supported from the city”, “I can do it in my own time”, and “I have experience of sexual intercourse”. In contrast, the reasons of do not want self-sampling were “I have no symptom”, and “I am anxious about doing the test by myself”. The awareness of HPV self-sampling was low with all subjects, and they have few the general knowledge of Cervical Cancer. ConclusionThere is a possibility to increase the number of young women who want self-sampling by using an HPV self-sampling trial of the opt-in method that also considers the emotions of the women. Young Japanese women who do not want self-sampling, tend to have a fear and anxiety toward self-sampling, in contrast, many of the women who conducted self-sampling prefer it. This study suggests the need of new practical education for self-sampling, including HPV infection, and Cervical Cancer prevention performed by clinicians, nurses and midwives.

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Women's perspectives on human papillomavirus self‐sampling in the context of the UK cervical screening programme

Cited by 25 publications

References 32 publications

Preferences for interventions designed to increase cervical screening uptake in non‐attending young women: How findings from a discrete choice experiment compare with observed behaviours in a trial

Preferences for interventions designed to increase cervical screening uptake in non‐attending young women: How findings from a discrete choice experiment compare with observed behaviours in a trial

Implementation Considerations Using HPV Self-Collection to Reach Women Under-Screened for Cervical Cancer in High-Income Settings

Awareness of Young Japanese Women on HPV Self-Sampling Trial using Opt-in Method

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