Impact of an educational intervention on women's knowledge and acceptability of human papillomavirus self-sampling: a randomized controlled trial in Cameroon.

Gaëtan Sossauer,Michel Zbinden,Gisèle K Fosso,Pierre Vassilakos,Pierre-Marie Tebeu,Patrick Petignat,Sarah Untiet,Matthew Law

doi:10.1371/journal.pone.0109788

Abstract

ObjectiveHuman papillomavirus (HPV) self-sampling (Self-HPV) may be used as a primary cervical cancer screening method in a low resource setting. Our aim was to evaluate whether an educational intervention would improve women's knowledge and confidence in the Self-HPV method.MethodWomen aged between 25 and 65 years old, eligible for cervical cancer screening, were randomly chosen to receive standard information (control group) or standard information followed by educational intervention (interventional group). Standard information included explanations about what the test detects (HPV), the link between HPV and cervical cancer and how to perform HPV self-sampling. The educational intervention consisted of a culturally tailored video about HPV, cervical cancer, Self-HPV and its relevancy as a screening test. All participants completed a questionnaire that assessed sociodemographic data, women's knowledge about cervical cancer and acceptability of Self-HPV.ResultsA total of 302 women were enrolled in 4 health care centers in Yaoundé and the surrounding countryside. 301 women (149 in the “control group” and 152 in the “intervention group”) completed the full process and were included into the analysis. Participants who received the educational intervention had a significantly higher knowledge about HPV and cervical cancer than the control group (p<0.05), but no significant difference on Self-HPV acceptability and confidence in the method was noticed between the two groups.ConclusionEducational intervention promotes an increase in knowledge about HPV and cervical cancer. Further investigation should be conducted to determine if this intervention can be sustained beyond the short term and influences screening behavior.Trials RegistrationInternational Standard Randomised Controlled Trial Number (ISRCTN) Register ISRCTN78123709

Highlights

In developed countries, cervical cancer screening with Pap smear and treatment of precancerous lesions has led to an important reduction of invasive cervical cancer incidence and mortality [1,2,3]
A total of 302 women were enrolled in 4 health care centers in Yaoundeand the surrounding countryside. 301 women (149 in the ‘‘control group’’ and 152 in the ‘‘intervention group’’) completed the full process and were included into the analysis
Participants who received the educational intervention had a significantly higher knowledge about human papillomavirus (HPV) and cervical cancer than the control group (p,0.05), but no significant difference on Self-HPV acceptability and confidence in the method was noticed between the two groups

Summary

Introduction

Cervical cancer screening with Pap smear and treatment of precancerous lesions has led to an important reduction of invasive cervical cancer incidence and mortality [1,2,3]. The method has important limitations such as highly variable sensitivity and specificity, which are very dependent on the examiner’s expertise [9] In this context, HPV testing may be an option for primary cervical cancer screening, as it is more sensitive and less dependent on the subjectivity and the training of health care professionals [10]. HPV testing may be an option for primary cervical cancer screening, as it is more sensitive and less dependent on the subjectivity and the training of health care professionals [10] It offers the option of being performed by women themselves with similar results compared to those performed by physicians [11]. As HPV testing only determines a potentially carcinogenic infection but no actual cervical lesion, VIA could be evaluated as an option to triage HPV positive women

Methods

Results

Conclusion