Cervical cancer screening using HPV tests on self-samples: attitudes and preferences of women participating in the VALHUDES study

• Published in: Archives of public health = Archives belges de santé publique 2021-08, Vol.79 (1), p.1-155, Article 155
• Main Authors: De Pauw, Hélène, Donders, Gilbert, Weyers, Steven, De Sutter, Philippe, Doyen, Jean, Tjalma, Wiebren A. A, Vanden Broeck, Davy, Peeters, Eliana, Van Keer, Severien, Vorsters, Alex, Arbyn, Marc
• Format: Article
• Language: English
• Subjects: Accuracy; Age; Attitudes; Cancer; Cervical cancer; Diagnosis; Health aspects; HPV; Human papillomavirus; Immunization; Medical equipment; Medical screening; Medical tests; Oncology, Experimental; Pap smear; Participation; Preferences; Prevention; Public health; Questionnaires; Risk reduction; Screening; Urine; Vagina; Women; Womens health
• ISSN: 2049-3258; 0778-7367; 2049-3258
• DOI: 10.1186/s13690-021-00667-4

Background Interventions to reach women who do not participate regularly in screening may reduce the risk of cervical cancer. Self-collection of a vaginal specimen has been shown to increase participation. The relative clinical accuracy of human papillomavirus (HPV) testing on first-void urine (with Colli-Pee) and on vaginal self-samples versus on cervical clinician-collected samples is being investigated in the VALHUDES trial. The current study assesses attitudes and experiences regarding self-sampling among women enrolled in VALHUDES. Methods Questionnaires from 515 women (age 25-64 years [N = 498]; < 25 [N = 10], age [greater than or equai to] 65 [N = 3], enrolled between December 2017 - January 2020) referred to colposcopy because of previous cervical abnormalities and enrolled in VALHUDES (NCT03064087) were analysed. Results Of the 515 participants, nearly all women confirmed that self-sampling may help in reaching under-screened women (93%). Nevertheless, 44% of the participants stated before starting collection that a clinician-collected sample is more effective than a self-collected sample. After self-sampling, the large majority of women (> 95%) declared that instructions for self-collection were clear, that collection was easy, and that they were confident about having performed the procedure correctly, for both urine and vaginal collection. However, a proportion of women found self-sampling unpleasant (9.5% [49/515] for urine collection; 18.6% [96/515] and 15.5% [80/515] for vaginal sampling with cotton swabs or plastic brushes, respectively). For their next screening round, 57% would prefer self-sampling whereas 41% opted for collection by a clinician. Among women preferring self-sampling, 53% would choose for urine collection, 38% for vaginal self-collection and 9% had no preference. Age did not modify preferences. Conclusion We conclude that both urine and vaginal self-sampling are well accepted by women, with a preference for urine sampling. Although the large majority of women are confident in their ability to perform self-sampling, four to five over ten women preferred specimen collection by a clinician. Trial registration The study VALHUDES was registered in ClinicalTrials.gov (identifier: NCT03064087). Keywords: Cervical cancer, Screening, Attitudes, Preferences, Human papillomavirus, HPV, Self-sampling, Urine, VALHUDES