title: Acceptability of unsupervised HPV self-sampling using written instructions.
abstract: OBJECTIVE
  The study measured the acceptability of self-sampling for human papillomavirus (HPV) testing in the context of cervical cancer screening. Women carried out self-sampling unsupervised, using a written instruction sheet.
  
  
  METHODS
  Participants were women attending either a family planning clinic or a primary care trust for routine cervical screening.
  
  
  METHODS
  Women (n = 902) carried out self-sampling for HPV testing and then a clinician did a routine cervical smear and HPV test. Immediately after having the two tests, participants completed a measure of acceptability for both tests, and answered questions about ease of using the instruction sheet and willingness to use self-sampling in the future.
  
  
  RESULTS
  The majority of women found self-sampling more acceptable than the clinician-administered test, but there was a lack of confidence that the test had been done correctly. Significant demographic differences in attitudes were found, with married women having more favourable attitudes towards self-sampling than single women, and Asian women having more negative attitudes than women in other ethnic groups. Intention to use self-sampling in the future was very high across all demographic groups.
  
  
  CONCLUSIONS
  Self-sampling for HPV testing was highly acceptable in this large and demographically diverse sample, and women were able to carry out the test alone, using simple written instructions. Consistent with previous studies, women were concerned about doing the test properly and this issue will need to be addressed if self-sampling is introduced. More work is needed to see whether the demographic differences we found are robust and to identify reasons for lower acceptability among single women and those from Asian background.
authors.affiliation: Cancer Research UK Health Behaviour Unit, Department of Epidemiology and Public Health, UCL, London, UK. j.waller@ucl.ac.uk
authors.forename: J
authors.initials: J
authors.lastname: Waller
authors.forename: K
authors.initials: K
authors.lastname: McCaffery
authors.forename: S
authors.initials: S
authors.lastname: Forrest
authors.forename: A
authors.initials: A
authors.lastname: Szarewski
authors.forename: L
authors.initials: L
authors.lastname: Cadman
authors.forename: J
authors.initials: J
authors.lastname: Austin
authors.forename: J
authors.initials: J
authors.lastname: Wardle
mesh_terms: D000328:Adult; D001294:Attitude to Health; D005260:Female; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000208:ethnology / Q000821:virology; D010353:Patient Education as Topic; D012648:Self Care; D011795:Surveys and Questionnaires; D014626:Vaginal Smears / Q000379:methods* / Q000523:psychology*