Acceptability of Women Self-Sampling versus Clinician-Collected Samples for HPV DNA Testing: A Systematic Review

Abstract

Objectives Female self-sampling for human papillomavirus (HPV) DNA testing is an alternative screening method that can potentially increase cervical cancer screening coverage. This review addresses the acceptability of HPV DNA testing using self-sampling compared with conventional clinician-collected sampling. Barriers to and others factors associated with acceptability of either method were also examined. Methods The following electronic resources were searched: Medline @EBSCOHOST(Medline), Embase, PubMed, and CINAHL databases. Manual searches were also conducted. The main outcome of interest was the acceptability of HPV DNA testing by self-sampling in comparison with clinician-collected sampling. Results In total, 23 articles were included in this systematic review. The majority (19 studies) were quantitative intervention studies and 4 studies were qualitative observational studies. Eleven studies reported a preference for self-sampling by women compared with clinician-collected sampling (64.7%–93%). The remaining studies found that women preferred clinician-collected sampling because mainly of respondents' lack of confidence in their ability to complete self-sampling correctly. In most articles reviewed, the studied associated factors, such as demographic factors (age, marital status, and ethnicity), socioeconomic factors (income, education level), reproductive factors (condom use, number of children, current use of contraception, and number of partners), and habits (smoking status) were not found to be significantly associated with preference. Conclusions Both methods of sampling were found to be acceptable to women. Self-sampling is cost-effective and could increase the screening coverage among underscreened populations. However, more information about the quality, reliability, and accuracy of self-sampling is needed to increase women's confidence about using to this method.

Variation in Cervical Cancer Screening Preferences among Medically Underserved Individuals in the United States: A Systematic Review

“…A preference for HPV self-testing over Pap testing emerged as a primary theme, with more participants preferring the HPV self-test in over 90% of screening modality studies. This overwhelming preference for self-testing over Pap testing is consistent with findings in prior systematic reviews of self-testing acceptability, which all found that participants in the majority of included studies preferred self-testing (22)(23)(24). The consistency of these results, viewed in concert with other reviews, has important implications for the incorporation of HPV self-testing into primary screening practice.…”

“…Huynh and colleagues conducted a systematic review of articles published through October 2008 about individual perceptions of HPV self-testing (22). In addition, two studies have systematically reviewed self-sampling acceptability (23,24). While these reviews found self-testing to be generally well received by patients, none have specifically reviewed preferences across the full range of approved screening delivery options or focused on medically underserved populations.…”

Acceptability of self- collection for human papillomavirus detection in the Eastern Cape, South Africa

“…At both study sites, women showed the same attitude regarding self-collection versus clinican collection samples for HPV DNA testing. The high rate of willingness to perform self-collection was not influenced by sociodemographic factors or any other factor studied as observed in previous studies [41,42]. This underscores the strong scientific basis for implementing self-collection in CC screening, thereby enabling women from communities and rural settings where CC screening programmes are presently not available to participate.…”

“…Mao and colleagues (2017) reported that women who prefer a clinician-collection want to have a one-on-one consultation with a clinician, so that they can address other issues they may have [44]. Other factors that women are raising include adequacy of the specimen and lack of confidence to perform self-collection correctly [42,45]. Therefore, our findings suggest that women should be given an opportunity to choose which method they prefer for specimen collection, when participating in the CC screening programme.…”

Assessing the feasibility of a rapid, high-volume cervical cancer screening programme using HPV self-sampling and digital colposcopy in rural regions of Yunnan, China

“…In a recent meta-analysis, the sensitivities and specificities of patient self-sampling compared with those collected by physicians for detecting HPV were comparable (74% and 88% vs 81% and 90%, respectively) 21 22. Furthermore, many studies implemented in various international regions show that the majority of women screened by the self-swab method are willing and able to perform the test 23 24…”