Self-Sampling for Human Papillomavirus Testing: Acceptability in a U.S. Safety Net Health System

Self-sampling for human papillomavirus 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 the acceptability of and experiences with mailed self-sampling kits for human papillom...

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Bibliographic Details
Published in:American journal of preventive medicine 2024-03, Vol.66 (3), p.540-547
Main Authors: Parker, Susan L., Amboree, Trisha L., Bulsara, Shaun, Daheri, Maria, Anderson, Matthew L., Hilsenbeck, Susan G., Jibaja-Weiss, Maria L., Zare, Mohammed, Schmeler, Kathleen M., Deshmukh, Ashish A., Chiao, Elizabeth Y., Scheurer, Michael E., Montealegre, Jane R.
Format: Article
Language:English
Subjects:
Early Detection of Cancer
Female
Human Papillomavirus Viruses
Humans
Male
Mass Screening
Papillomaviridae
Papillomavirus Infections - diagnosis
Patient Acceptance of Health Care
Self Care
Uterine Cervical Neoplasms - prevention & control
Vaginal Smears
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Summary:Self-sampling for human papillomavirus 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 the acceptability of and experiences with mailed self-sampling kits for human papillomavirus testing among underscreened patients in a safety net health system. A nested telephone survey was administered between 2021 and 2023 to a sample (n=272) of the 2,268 participants enrolled in the Prospective Evaluation of Self-Testing to Increase Screening 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 nonusers were asked about their experiences. Prevalent barriers to provider-performed screening included perceived discomfort of pelvic examination (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 nonusers (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%). Prospective Evaluation of Self-Testing to Increase Screening trial participants generally had a positive experience with self-sampling for human papillomavirus testing. Increased comfort and reduced embarrassment/anxiety with self-sampling are relevant attributes because these were the most prevalent reported barriers to provider-performed screening. High acceptability suggests potentially high uptake when self-sampling for human papillomavirus testing receives regulatory approval and is available in safety net health systems.
ISSN:0749-3797
1873-2607
1873-2607
DOI:10.1016/j.amepre.2023.10.020