Abstract
As human papillomavirus (HPV) self-sampling continues to emerge as a potential cervical cancer screening strategy in the United States, it is necessary to examine women's acceptability of this screening approach. Furthermore, since several HPV self-sampling devices exist, it is important to determine if women's preferences differ by device type. We conducted an online survey in Fall 2017 with a national sample of women (n = 605) ages 21–65 years (the recommended age range for cervical cancer screening). Multivariable linear regression identified correlates of women's willingness to use an HPV self-sample at home. We used repeated measures analysis of variance to determine if preferences differed across four self-sampling devices: Evalyn® Brush (Device A), HerSwab® (Device B), Catch-All® Swab (Device C), and Qvintip® (Device D). Most women were willing to use an HPV self-sample at home (mean = 4.03 [possible range: 1–5], standard deviation = 1.09, 72.7% indicated “probably willing” or “definitely willing”). The most common concerns about self-sampling were related to test accuracy (53.1%) and obtaining the sample incorrectly (51.1%). Women were more willing to use an HPV self-sample at home if they reported greater perceived severity of cervical cancer (β = 0.16), reported an annual income less than $50,000 (β = 0.13), or were a former smoker (β = 0.11). Women were more willing to use Device A (mean = 3.72, 67.6% indicated “agree” or “strongly agree”), Device C (mean = 3.86, 73.9% indicated “agree” or “strongly agree”), and Device D (mean = 3.81, 72.1% indicated “agree” or “strongly agree”) than Device B (mean = 3.36, 49.4% indicated “agree” or “strongly agree”; all p < 0.05). Acceptability of HPV self-sampling as a cervical cancer screening strategy is generally high among women. Future efforts should consider the potential impact that device type may have on women's use of an HPV self-sample at home.
Highlights
Persistent infection with high-risk types of human papillomavirus (HPV) cause most cases of cervical cancer,[1] and nearly 30% of adult women in the United States are infected with at least one high-risk type.[2]
The current study examined the acceptability of HPV self-sampling as a cervical cancer screening strategy among a national sample of women
We considered differences to exist if an interaction term between a demographic characteristic and self-sampling device type had p < 0.05
Summary
Persistent infection with high-risk types of human papillomavirus (HPV) cause most cases of cervical cancer,[1] and nearly 30% of adult women in the United States are infected with at least one high-risk type.[2] Current guidelines recommend that women ages 21–65 years should be screened for cervical cancer.[3] Women ages 21–29 years should receive cytology (i.e., a Pap test) every 3 years, and women ages 30–65 years should receive a combination of cytology and a clinic-based. HPV test every 5 years, a clinic-based HPV test alone every 5 years, or cytology alone every 3 years.[3] Despite recommendations, nearly 20% of U.S women are not within these screening guidelines.[4] Unscreened and underscreened women are at increased risk for cervical cancer since more than half of new cases of cervical cancer occur among such women.[5].
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