Questionnaire-Based Study on the Knowledge of Cervical Cancer and Attitude and Perception Toward Self-Sampling Method of Screening, Among Women in Sikkim, India.

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Cervical cancer (CC) is the second most common cancer among women in India and in Sikkim. Screening helps in prevention and early detection of the disease; however, pelvic examination for smear collection is not preferred by many. Self-sampling method can be a good alternative for collection of smears, thus increasing screening uptake. Therefore, a study was conducted to evaluate perception about self-sampling method of screening among women in Sikkim. A total of 210 women who consented for this study were screened for cervical cancer using Pap smear and HPV DNA. Women were taught to collect their self-sample for HPV DNA test. Questionnaires were used to assess their attitude toward self-sampling prior to collection of samples and perception, post-collection. Seventy-percent women knew that CC is the most common cancer among women in Sikkim. 73% knew that it could be prevented, but only 57% had knowledge about screening facilities in Sikkim. 50% women knew about HPV vaccination program in Sikkim. 96% women had never done a self-sampling, while 67% had never heard about it. There was a significant change (p value < 0.00001) in perception toward self-sampling after the procedure. Comparative analysis showed that women found self-collection easier than expected. If they had a choice, they would prefer self-sampling over physician sampling; however, due to their trust in physicians they still believed physician collected sample would be better. Self-sampling is a socially acceptable screening technique and can increase compliance among socially shy community.