title: Acceptability of self-sample human papillomavirus testing among medically underserved women visiting the emergency department.
abstract: OBJECTIVE
  Self-sample human papillomavirus (HPV) testing in public emergency departments (EDs) may be a viable strategy to opportunistically screen women who otherwise do not attend for regular Papanicolaou test-based cervical cancer screening. We describe the acceptability of self-sample HPV testing among women presenting to two high-volume, urban EDs that primarily care for the medically underserved.
  
  
  METHODS
  In 2014, a total of 210 women 21 years of age and older were recruited from two public ED waiting areas following a two-stage cluster sampling design. Questionnaire items inquired about demographics, healthcare access and utilization, history of cervical cancer screening, and acceptability of self-sample HPV testing. Descriptive analyses were performed.
  
  
  RESULTS
  Overall, 34.8% of participants were considered screening non-attendees based on their adherence to the current guidelines for Pap testing every three years. Acceptability of self-sample HPV testing was high, with over 85% of participants reporting that they would be willing to use the test if available. A smaller proportion (58%) was deemed likely to accept self-sample HPV testing in a public ED restroom setting. Primary concerns expressed by women were that the sampling may not be done correctly (64%) and that they may not know how to perform the sampling (39%).
  
  
  CONCLUSIONS
  Opportunistic self-sample HPV testing is acceptable to women seeking care at a high-volume, urban emergency care center. The use of this intervention potentially offers a unique strategy to improve cervical cancer screening among high-risk women who otherwise do not attend for regular screening.
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, United States. Electronic address: jrmontea@bcm.edu.
authors.forename: Jane R
authors.initials: JR
authors.lastname: Montealegre
authors.affiliation: The University of Texas School of Medicine, Houston, TX, United States.
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Landgren
authors.affiliation: Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, United States; Division of Gynecologic Oncology, Baylor College of Medicine, Houston, TX, United States; Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, United States.
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Anderson
authors.affiliation: Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, United States.
authors.forename: Shkelzen
authors.initials: S
authors.lastname: Hoxhaj
authors.affiliation: Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, United States.
authors.forename: Sandra
authors.initials: S
authors.lastname: Williams
authors.affiliation: Department of Emergency Medicine, The University of Texas School of Medicine, Houston, TX, United States.
authors.forename: David J
authors.initials: DJ
authors.lastname: Robinson
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, United States.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Scheurer
authors.affiliation: Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States; Division of Gynecologic Oncology, Lyndon Baines Johnson Hospital, Harris Health System, Houston, TX, United States.
authors.forename: Lois M
authors.initials: LM
authors.lastname: Ramondetta
mesh_terms: D000328:Adult; D001741:Black or African American; D004636:Emergency Service, Hospital; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008507:Medically Underserved Area; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000208:ethnology; D010342:Patient Acceptance of Health Care; D016353:Self-Examination / Q000379:methods* / Q000592:standards*; D013048:Specimen Handling / Q000379:methods / Q000523:psychology / Q000592:standards; D044465:White People
keywords: Cervical cancer screening; Emergency departments; Human papillomavirus; Self-testing