title: Feasibility of at-home self-sampling for HPV testing as an appropriate screening strategy for nonparticipants in Switzerland: preliminary results of the DEPIST study.
abstract: OBJECTIVE
  Nonattendees to cervical cancer screening are at a higher risk of developing cervical cancer. This study assessed women's willingness to perform a home-based self-sampling for human papillomavirus testing (Self-HPV) and explored the feasibility of establishing a home-based Self-HPV screening strategy in Switzerland.
  
  
  METHODS
  Underscreened women (n = 158) who had not underwent a Pap test in the preceding 3 years were recruited between September 2011 and September 2013. Participants completed 2 questionnaires evaluating reasons for non-attendance at a screening program, sociodemographic issues, and satisfaction with and acceptability of the Self-HPV. Descriptive data and multivariate logistic regression were used to identify variables associated with women's willingness to perform at-home self-sampling for HPV testing.
  
  
  RESULTS
  Lack of time because of work or childcare was the most common reason for nonattendance at a screening program. One hundred six women (82%) preferred the Self-HPV because it is easy to perform, convenient, comfortable, and private. Women were more likely to accept the Self-HPV as a future screening strategy if they had missed cervical cancer screening in the past because of lack of time (odds ratio [OR] = 6.2, 95% confidence interval [CI] = 1.6-23.6; p < .01). Twenty-six women felt pain during self-sampling. Previous negative experiences with screening and stress during sampling were associated with higher risk for pain (OR = 7.14, 95% CI = 2.0-25.3, p < .01 and OR = 4.73, 95% CI = 1.5-14.5, p < .01, respectively).
  
  
  CONCLUSIONS
  The Self-HPV was accepted by nonattendees of cervical cancer screening programs. Self-sampling may promote screening among the unscreened and underscreened population of women in Switzerland while overcoming some practical barriers.
authors.affiliation: 1Division of Gynecology, Department of Gynecology and Obstetrics, Geneva University Hospitals; and 2Geneva Foundation for Medical Education and Research, Geneva, Switzerland.
authors.forename: Rosa
authors.initials: R
authors.lastname: Catarino
authors.forename: Pierre
authors.initials: P
authors.lastname: Vassilakos
authors.forename: Heidrun
authors.initials: H
authors.lastname: Stadali-Ullrich
authors.forename: Isabelle
authors.initials: I
authors.lastname: Royannez-Drevard
authors.forename: Cécile
authors.initials: C
authors.lastname: Guillot
authors.forename: Patrick
authors.initials: P
authors.lastname: Petignat
mesh_terms: D000328:Adult; D000368:Aged; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000175:diagnosis*; D010342:Patient Acceptance of Health Care; D012648:Self Care / Q000379:methods*; D013048:Specimen Handling / Q000379:methods*; D011795:Surveys and Questionnaires; D013557:Switzerland