Self-Sampling for Human Papillomavirus Testing: Acceptability in a U.S. Safety Net Health System
Menée aux Etats-Unis à partir d'une enquête téléphonique réalisée entre 2021 et 2023 auprès d'un échantillon de 272 femmes parmi les 2 268 incluses dans un essai évaluant un kit d'auto-prélèvement vaginal pour test HPV, cette étude examine l'acceptabilité de ce kit, les expériences concernant son utilisation ainsi que les raisons expliquant sa non-utilisation
Introduction : Self-sampling for human papillomavirus (HPV) testing is increasingly recognized as a strategy to expand cervical cancer screening access and utilization. Acceptability is a key determinant of uptake. This study assesses acceptability of and experiences with mailed self-sampling kits for HPV testing among underscreened patients in a safety net health system.
Methods : A nested telephone survey was administered between 2021-2023 to a sample (n=272) of the 2,268 participants enrolled in the Prospective Evaluation of Self-Testing to Increase Screening (PRESTIS) trial. Trial participants include patients of a safety net health system aged 30-65 years who were not up-to-date on screening. Participants were asked about barriers to provider-performed screening. Kit users and non-users were asked about their experiences.
Results : Prevalent barriers to provider-performed screening included perceived discomfort of pelvic exam (69.4%), being uncomfortable with male providers (65.4%), and embarrassment (57.0%). Among participants who reported using the mailed kit (n=164), most reported good experiences (84.8%). Most reported self-sampling as more/equally convenient (89.0%); less/equally embarrassing (99.4%); and less/equally stressful (95.7%) than provider-performed screening. Among kit non-users (n=43), reasons for not using the kit included forgetting about it (76.7%), preferring provider-performed screening (76.7%), and fearing cancer (67.4%).
Conclusions : PRESTIS trial participants generally had a positive experience with self-sampling for HPV testing. Increased comfort and reduced embarrassment/anxiety with self-sampling are relevant attributes as these were the most prevalent reported barriers to provider-performed screening. High acceptability suggests potentially high uptake when self-sampling for HPV testing receives regulatory approval and is available in safety net health systems.
American Journal of Preventive Medicine , article en libre accès, 2022