Abstract
IntroductionCervical cancer is the most common cancer among women in Sub-Saharan Africa. Cervical cancer is treatable if detected timeously, yet only 20% of South African women have ever been for a Pap smear in their lifetime due to limited access to screening, transport or child care responsibilities.ObjectiveTo evaluate the acceptability of self-collection for cervical cancer screening. We aimed to identify which self-collection device women prefer and if they would consider using them for routine cervical cancer screening.MethodsHIV-positive women (>18 years) from urban and rural HIV clinics were interviewed following an education session on HIV, human papillomavirus (HPV) and cervical cancer. Participants were shown three self-collection devices; (i) an Evalyn cervical brush, (ii) a Delphilavager and (iii) a tampon-like plastic wand before completing a short questionnaire.ResultsA total of 106 women from the urban (n = 52) and rural (n = 54) clinic were interviewed. Overall 51% of women preferred the cervical brush, while fewer women preferred the tampon-like plastic wand (31%) or lavage sampler (18%). More than 75% of women from the rural site preferred the cervical brush, compared to 22% from the urban site (p < 0.001). Women from the urban clinic preferred the tampon-like plastic wand (45%) and then the lavage sampler (33%), as compared to women from the rural clinic (19% and 4%, respectively).ConclusionWomen from urban or rural settings had different preferences for the various self-collection devices. Patient self-collection with HPV testing may be an acceptable way to improve coverage to cervical cancer screening in high risk HIV-seropositive women.
Highlights
Cervical cancer is the most common cancer among women in Sub-Saharan Africa
human papillomavirus (HPV) screening through patient self-collection has been shown to have a high sensitivity and specificity for the detection of high risk HPV types which can lead to cervical cancer
Self-collection sampling for HPV testing could be a potential alternative to Pap smear test, provided that women who test positive by any method get timely follow-up and care.[14]
Summary
Cervical cancer is the most common cancer among women in Sub-Saharan Africa. Cervical cancer is treatable if detected timeously, yet only 20% of South African women have ever been for a Pap smear in their lifetime due to limited access to screening, transport or child care responsibilities. Patient self-collection with HPV testing may be an acceptable way to improve coverage to cervical cancer screening in high risk HIV-seropositive women. In a study amongst women with ICC (167 in Ghana, 192 in Nigeria and 300 in South Africa), HPV-positivity rate in ICC cases was 90% (515/570) with HPV16 (51%), HPV18 (17%), HPV35 (9%), HPV45 (7%), HPV33 (4%) and HPV52 (2%) being the most common HPV types detected.[6] Women with persistent HPV infections are at high risk of cervical lesions and cancer [7]. Self-collection sampling for HPV testing could be a potential alternative to Pap smear test, provided that women who test positive by any method get timely follow-up and care.[14] Self-testing could be helpful in several scenarios in South Africa. We aimed to identify which self-collection device women prefer and if they would be willing to use it for routine cervical cancer screening
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