Acceptability of self-sampling in Portuguese women: the good, the bad or the ugly?
Jani Silva A B C D , Fátima Cerqueira C E and Rui Medeiros A C D FA Molecular Oncology and Viral Pathology GRP–IC, Portuguese Institute of Oncology of Porto (IPO Porto), Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal.
B Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
C FP-ENAS Research Unit, UFP Energy, Environment and Health Research Unit, CEBIMED, Biomedical Research Centre, Fernando Pessoa University, Praça 9 de Abril, 349, 4249-004, Porto, Portugal.
D LPCC, Research Department – Portuguese League Against Cancer (LPPC–NRN), Estrada Interior da Circunvalação, 4200-172, Porto, Portugal.
E CIIMAR/CIMAR, Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Terminal dos Cruzeiros do Porto de Leixões, Avenida General Norton de Matos S/N, 4450-208, Matosinhos, Portugal.
F Corresponding author. Email: ruimedei@ipoporto.min-saude.pt
Sexual Health 14(3) 298-300 https://doi.org/10.1071/SH16077
Submitted: 3 May 2016 Accepted: 26 October 2016 Published: 9 January 2017
Abstract
Background: Self-sampling is a less costly approach that has been used for human papillomavirus (HPV) testing. Methods: A cross-sectional study involving 313 Portuguese women assessed the acceptability of cervicovaginal self-sampling. Results: Self-sampling was a well-accepted method [75.7%; 95% confidence interval (CI) 70.5–80.2], and the majority of women felt no pain (67.4%; 95% CI 61.9–72.5), no discomfort (70.9%; 95% CI 65.5–75.8) and no complexity (76.4%; 95% CI 71.2–80.9). The willingness to repeat self-sampling was high (89.5%; 95% CI 85.4–92.5). Compared to physician-sampling, women reported a preference for self-sampling (58.1%; 95% CI 52.5–63.6), as it was more comfortable (67.1%; 95% CI 61.5–72.2) and caused less pain (16.3%; 95% CI 12.5–20.9) and embarrassment (13.4%; 95% CI 9.9–17.8). Conclusion: Offering self-sampling for HPV testing may improve screening participation rates and overcome women’s embarrassment regarding physician examination.
Additional keywords: acceptance, cervical cancer, HPV, physician-sampling, prevention, self-collected samples.
References
[1] Petignat P, Faltin DL, Bruchim I, Tramer MR, Franco EL, Coutlee F. Are self-collected samples comparable to physician-collected cervical specimens for human papillomavirus DNA testing? A systematic review and meta-analysis. Gynecol Oncol 2007; 105 530–5.| Are self-collected samples comparable to physician-collected cervical specimens for human papillomavirus DNA testing? A systematic review and meta-analysis.Crossref | GoogleScholarGoogle Scholar |
[2] Silva J, Ribeiro J, Sousa H, Cerqueira F, Teixeira AL, Baldaque I, Osorio T, Medeiros R. Oncogenic HPV types infection in adolescents and university women from North Portugal: from self-sampling to cancer prevention. J Oncol 2011; 953469
[3] Sutton S, Rutherford C. Sociodemographic and attitudinal correlates of cervical screening uptake in a national sample of women in Britain. Soc Sci Med 2005; 61 2460–5.
| Sociodemographic and attitudinal correlates of cervical screening uptake in a national sample of women in Britain.Crossref | GoogleScholarGoogle Scholar |
[4] Webb R, Richardson J, Esmail A, Pickles A. Uptake for cervical screening by ethnicity and place-of-birth: a population-based cross-sectional study. J Public Health (Oxf) 2004; 26 293–6.
| Uptake for cervical screening by ethnicity and place-of-birth: a population-based cross-sectional study.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2cvos1CitQ%3D%3D&md5=a630369f6eca3c7e164fd8a47c351888CAS |
[5] Odesanmi TY, Wasti SP, Odesanmi OS, Adegbola O, Oguntuase OO, Mahmood S. Comparative effectiveness and acceptability of home-based and clinic-based sampling methods for sexually transmissible infections screening in females aged 14–50 years: a systematic review and meta-analysis. Sex Health 2013; 10 559–69.
| Comparative effectiveness and acceptability of home-based and clinic-based sampling methods for sexually transmissible infections screening in females aged 14–50 years: a systematic review and meta-analysis.Crossref | GoogleScholarGoogle Scholar |
[6] Paudyal P, Llewellyn C, Lau J, Mahmud M, Smith H. Obtaining self-samples to diagnose curable sexually transmitted infections: a systematic review of patients’ experiences. PLoS One 2015; 10 e0124310
| Obtaining self-samples to diagnose curable sexually transmitted infections: a systematic review of patients’ experiences.Crossref | GoogleScholarGoogle Scholar |
[7] Anhang R, Nelson JA, Telerant R, Chiasson MA, Wright TC. Acceptability of self-collection of specimens for HPV DNA testing in an urban population. J Womens Health (Larchmt) 2005; 14 721–8.
| Acceptability of self-collection of specimens for HPV DNA testing in an urban population.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2MrlvVeruw%3D%3D&md5=57ae2e78843c7b41b60fca6fdb0731c3CAS |
[8] Harper DM, Noll WW, Belloni DR, Cole BF. Randomized clinical trial of PCR-determined human papillomavirus detection methods: self-sampling versus clinician-directed–biologic concordance and women’s preferences. Am J Obstet Gynecol 2002; 186 365–73.
| Randomized clinical trial of PCR-determined human papillomavirus detection methods: self-sampling versus clinician-directed–biologic concordance and women’s preferences.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD38XivFCrsbo%3D&md5=fe9371784bcf2acbb96eebf1b0dd8ba1CAS |
[9] Dzuba IG, Diaz EY, Allen B, Leonard YF, Lazcano Ponce EC, Shah KV. The acceptability of self-collected samples for HPV testing vs. the Pap test as alternatives in cervical cancer screening. J Womens Health Gend Based Med 2002; 11 265–75.
| The acceptability of self-collected samples for HPV testing vs. the Pap test as alternatives in cervical cancer screening.Crossref | GoogleScholarGoogle Scholar |
[10] Lorenzi AT, Fregnani JH, Possati-Resende JC, Neto CS, Villa LL, Longatto-Filho A. Self-collection for high-risk HPV detection in Brazilian women using the careHPV™ test. Gynecol Oncol 2013; 131 131–4.
| Self-collection for high-risk HPV detection in Brazilian women using the careHPV™ test.Crossref | GoogleScholarGoogle Scholar |
[11] Longatto-Filho A, Roteli-Martins C, Hammes L, Etlinger D, Pereira SM, Erzen M, Branca M, Naud P, Derchain SF, Sarian LO, Matos J, Gontijo R, Lima T, Maeda MY, Tatti S, Syrjanen S, Syrjanen K. Self-sampling for human papillomavirus (HPV) testing as cervical cancer screening option. Experience from the LAMS study. Eur J Gynaecol Oncol 2008; 29 327–32.
| 1:STN:280:DC%2BD1crjsFOjtw%3D%3D&md5=6f5bf006e7af412a372f23c4d56a96d8CAS |
[12] Nobbenhuis MA, Helmerhorst TJ, van den Brule AJ, Rozendaal L, Jaspars LH, Voorhorst FJ, Verheijen RHM, Meijer CJLM. Primary screening for high risk HPV by home obtained cervicovaginal lavage is an alternative screening tool for unscreened women. J Clin Pathol 2002; 55 435–9.
| Primary screening for high risk HPV by home obtained cervicovaginal lavage is an alternative screening tool for unscreened women.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD38zhs1WrsA%3D%3D&md5=52930a5e9e44cdd23f498a3c8071798aCAS |
[13] Sultana F, Mullins R, Murphy M, English DR, Simpson JA, Drennan KT, Heley S, Wrede DC, Brotherton JML, Saville M, Gertig DM. Women’s views on human papillomavirus self-sampling: focus groups to assess acceptability, invitation letters and a test kit in the Australian setting. Sex Health 2015; 12 279–86.
| Women’s views on human papillomavirus self-sampling: focus groups to assess acceptability, invitation letters and a test kit in the Australian setting.Crossref | GoogleScholarGoogle Scholar |
[14] Gaydos CA, Rizzo-Price PA, Barnes M, Dwyer K, Wood BJ, Hogan MT. The use of focus groups to design an internet-based program for chlamydia screening with self-administered vaginal swabs: what women want. Sex Health 2006; 3 209–15.
| The use of focus groups to design an internet-based program for chlamydia screening with self-administered vaginal swabs: what women want.Crossref | GoogleScholarGoogle Scholar |
[15] Garland SM, Tabrizi SN. Diagnosis of sexually transmitted infections (STI) using self-collected non-invasive specimens. Sex Health 2004; 1 121–6.
| Diagnosis of sexually transmitted infections (STI) using self-collected non-invasive specimens.Crossref | GoogleScholarGoogle Scholar |
[16] Brotman RM. Vaginal microbiome and sexually transmitted infections: an epidemiologic perspective. J Clin Invest 2011; 121 4610–7.
| Vaginal microbiome and sexually transmitted infections: an epidemiologic perspective.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3MXhs1ShsLrP&md5=fd8a721e1931d30b5dae9386be4fc59cCAS |
[17] Ortiz AP, Alejandro N, Perez CM, Otero Y, Soto-Salgado M, Palefsky JM, Tortolero-Luna G, Romaguera J. Acceptability of cervical and anal HPV self-sampling in a sample of Hispanic women in Puerto Rico. P R Health Sci J 2012; 31 205–12.
[18] Harper DM, Raymond M, Noll WW, Belloni DR, Duncan LT, Cole BF. Tampon samplings with longer cervicovaginal cell exposures are equivalent to two consecutive swabs for the detection of high-risk human papillomavirus. Sex Transm Dis 2002; 29 628–36.
| Tampon samplings with longer cervicovaginal cell exposures are equivalent to two consecutive swabs for the detection of high-risk human papillomavirus.Crossref | GoogleScholarGoogle Scholar |
[19] Sultana F, Mullins R, English DR, Simpson JA, Drennan KT, Heley S, Wrede DC, Brotherton JML, Saville M, Gertig DM. Women’s experience with home-based self-sampling for human papillomavirus testing. BMC Cancer 2015; 15 849
| Women’s experience with home-based self-sampling for human papillomavirus testing.Crossref | GoogleScholarGoogle Scholar |
[20] Duke P, Godwin M, Ratnam S, Dawson L, Fontaine D, Lear A, Traverso-Yepez M, Graham W, Ravalia M, Mugford G, Pike A, Fortier J, Peach M. Effect of vaginal self-sampling on cervical cancer screening rates: a community-based study in Newfoundland. BMC Womens Health 2015; 15 47
| Effect of vaginal self-sampling on cervical cancer screening rates: a community-based study in Newfoundland.Crossref | GoogleScholarGoogle Scholar |
[21] Medeiros R, Ramada D. Knowledge differences between male and female university students about human papillomavirus (HPV) and cervical cancer: implications for health strategies and vaccination. Vaccine 2010; 29 153–60.
| Knowledge differences between male and female university students about human papillomavirus (HPV) and cervical cancer: implications for health strategies and vaccination.Crossref | GoogleScholarGoogle Scholar |