The acceptability of self-collected samples for HPV testing vs. the pap test as alternatives in cervical cancer screening.
OBJECTIVE
To explore the acceptability of the self-collection of samples for human papillomavirus (HPV) testing in comparison with that of the Pap test.


METHODS
The study population consisted of 1069 women 20 years and older who were eligible for coverage through the Mexican Institute of Social Security (IMSS). These women were randomly selected among participants in a larger study to evaluate the use of HPV testing as an alternative in cervical cancer screening. All participants provided a self-collected vaginal sample for HPV testing according to explicit instructions and underwent a Pap test. Afterwards, each woman was interviewed about her experience and opinion regarding the two procedures. Acceptability was measured by a calculated score based on discomfort, pain, embarrassment, privacy, perception of personal treatment during the Pap test, and understanding of how to perform the self-sampling method.


RESULTS
Ninety-three percent of women experienced sufficient privacy with the Pap test, whereas 98% of women reported that privacy with the self-sampling procedure was acceptable. The Pap test consistently provoked more discomfort, pain, and embarrassment than self-sampling. Sixty-eight percent of the women who indicated a test preference chose self-sampling. Preference for this method was positively associated with monthly household income. Women reported a preference for self-sampling because it is more comfortable (71.2%) and causes less embarrassment (55.8%).


CONCLUSIONS
Self-sampling is more acceptable than the Pap test and could improve coverage rates of early detection programs. The incorporation of self-collected samples to detect HPV could encourage participation in screening programs among those women who reject the Pap test because of the necessary pelvic examination.
Dzuba
Ilana G
IG
The Johns Hopkins University School of Public Health, Baltimore, Maryland, USA.
Díaz
Elsa Yunes
EY
Allen
Betania
B
Leonard
Yvonne Flores
YF
Lazcano Ponce
Eduardo C
EC
Shah
Keerti V
KV
Bishai
David
D
Lorincz
Attila
A
Ferris
Daron
D
Turnbull
Bernardo
B
Hernández Avila
Mauricio
M
Salmerón
Jorge
J
D000328:Adult; D004867:Equipment Design; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D008800:Mexico; D008875:Middle Aged; D010147:Pain Measurement; D027383:Papillomaviridae / Q000302:isolation & purification*; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D012648:Self Care; D013048:Specimen Handling / Q000379:methods; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D014626:Vaginal Smears