title: Women's views on human papillomavirus self-sampling: focus groups to assess acceptability, invitation letters and a test kit in the Australian setting.
abstract: Background The study evaluated acceptability, invitation letters and the test kit for a trial of human papillomavirus (HPV) self-sampling among never- and under-screened women in Australia.
  
  
  METHODS
  Victorian women, 30-69 years, who had never had a Pap test or were overdue for one, participated. Four focus groups including eight to nine participants segmented by age (30-49 and 50-69 years) and screening history (never- and under-screened) were conducted in August 2013. Discussions were recorded and transcribed verbatim and data analysed using thematic content analysis.
  
  
  RESULTS
  The response to the concept of HPV self-sampling was positive. Decision-making was largely influenced by the content of a pre-invitation letter. Appealing features of self-sampling were cost (free), convenience (home-based) and anticipated less discomfort (with a swab) than a Pap test. Small kits that fit in mailboxes were preferred over post office parcel collection. The perceived barriers include concerns about test accuracy and lack of confidence that a home-based test would give the same results as a physician administered test. Women wanted information on the timing of receipt of the results and information about the organisation providing the test.
  
  
  CONCLUSIONS
  HPV self-sampling is a possible alternative for Australian women who are reluctant to have a Pap test and may increase the likelihood of participation in cervical cancer screening if women's concerns about it can be addressed. The findings of this study are relevant for researchers, policymakers and practitioners implementing self-sampling for under-screened women as part of cervical screening programs.
authors.affiliation: Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Level 3, 207 Bouverie Street, The University of Melbourne, Vic. 3010, Australia.
authors.forename: Farhana
authors.initials: F
authors.lastname: Sultana
authors.affiliation: Cancer Council Victoria, 615St Kilda Road, Melbourne, Vic. 3004, Australia.
authors.forename: Robyn
authors.initials: R
authors.lastname: Mullins
authors.affiliation: Michael Murphy Research, 5/8A Dickens Street, Elwood, Vic. 3184, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Murphy
authors.affiliation: Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Level 3, 207 Bouverie Street, The University of Melbourne, Vic. 3010, Australia.
authors.forename: Dallas R
authors.initials: DR
authors.lastname: English
authors.affiliation: Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Level 3, 207 Bouverie Street, The University of Melbourne, Vic. 3010, Australia.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Simpson
authors.affiliation: VCS Inc., 265 Faraday Street, Carlton, Vic. 3053, Australia.
authors.forename: Kelly T
authors.initials: KT
authors.lastname: Drennan
authors.affiliation: VCS Inc., 265 Faraday Street, Carlton, Vic. 3053, Australia.
authors.forename: Stella
authors.initials: S
authors.lastname: Heley
authors.affiliation: Royal Women's Hospital, Locked Bag 300, Corner Flemington Road and Grattan Street, Parkville, Vic. 3052, Australia.
authors.forename: C David
authors.initials: CD
authors.lastname: Wrede
authors.affiliation: Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Level 3, 207 Bouverie Street, The University of Melbourne, Vic. 3010, Australia.
authors.forename: Julia M L
authors.initials: JM
authors.lastname: Brotherton
authors.affiliation: VCS Inc., 265 Faraday Street, Carlton, Vic. 3053, Australia.
authors.forename: Marion
authors.initials: M
authors.lastname: Saville
authors.affiliation: Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Level 3, 207 Bouverie Street, The University of Melbourne, Vic. 3010, Australia.
authors.forename: Dorota M
authors.initials: DM
authors.lastname: Gertig