Abstract
This study aims to investigate acceptance of vaginal self-sampling for high-risk human papilloma virus (HPV) among long-term screening non-attenders at increased cervical cancer risk and to identify leverage points to promote screening adherence among these women. Forty-three long-term screening non-attenders performed home vaginal self-sampling for HPV, had positive HPV results, and subsequently attended gynecologic examination. Sixteen (37.2%) had high-grade cervical intraepithelial neoplasia (CIN2 or 3), and two had invasive cervical cancer. Forty-one of these women completed a questionnaire concerning Specific Knowledge about HPV, CIN, and cervical cancer, potential barriers to screening and views about self-sampling. Results were compared with 479 women treated for CIN2+ who attended gynecologic follow-up and also performed self-sampling. Significant multivariate predictors of long-term non-attender status compared with referents were low Specific Knowledge, high confidence in self-sampling, and potential barriers—refraining from activity to attend gynecologic examination, needing another's help to attend, and long travel time. Non-attenders citing fear/refraining from gynecologic examination as why they preferred self-sampling significantly more often had lowest Specific Knowledge compared with other non-attenders. All non-attenders could envision themselves doing self-sampling again while only 74% of referents endorsed this statement (p = 0.0003). We conclude that HPV self-sampling is an acceptable option for women at increased cervical cancer risk who have been long-term screening non-attenders. Educational outreach to enhance Specific Knowledge about HPV, CIN and cervical cancer is critical. Those non-attenders who explicitly avoid gynecologic examinations need special attention. Trial Registry: Clinicaltrials.gov NCT02750124
Highlights
Cervical cancer (CC) continues to be a frequent cause of cancer death worldwide, in less developedAngeles, USA 5 School of Medical Sciences, Faculty of Medicine and Health, ÖrebröUniversity, Örebrö, Sweden regions, both within and outside Europe [1]
Wherever CC screening programs are in place, CC is preponderantly found in non-participants in these programs [2]
The questionnaire included socio-demographic queries, travel time to and from the examination, and related logistic issues: time taken from work, refraining from some activity, and needing another person's help to attend gynecologic exam
Summary
University, Örebrö, Sweden regions, both within and outside Europe [1]. Through screening and treatment of cervical dysplasia, CC mortality has been markedly reduced. Wherever CC screening programs are in place, CC is preponderantly found in non-participants in these programs [2]. In 2010, the participation rate in this program was 73%, with CC mortality the 9th lowest in the European Union [3]. Notwithstanding these achievements, in Sweden, close to 500 women are diagnosed every year with CC from which about 200 women die annually [4]
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have