Acceptability of self-sample human papillomavirus testing among medically underserved women visiting the emergency department

• Published in: Gynecologic oncology 2015-08, Vol.138 (2), p.317-322
• Main Authors: Montealegre, Jane R, Landgren, Rachel M, Anderson, Matthew L, Hoxhaj, Shkelzen, Williams, Sandra, Robinson, David J, Scheurer, Michael E, Ramondetta, Lois M
• Format: Article
• Language: English
• Subjects: Adult; African Americans; Cervical cancer screening; Emergency departments; Emergency Service, Hospital; European Continental Ancestry Group; Female; Hematology, Oncology and Palliative Medicine; Hispanic Americans; Human papillomavirus; Humans; Medically Underserved Area; Obstetrics and Gynecology; Papillomaviridae - isolation & purification; Papillomavirus Infections - diagnosis; Papillomavirus Infections - ethnology; Patient Acceptance of Health Care; Self-Examination - methods; Self-Examination - standards; Self-testing; Specimen Handling - methods; Specimen Handling - psychology; Specimen Handling - standards
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2015.05.028

Abstract Objective Self-sample human papillomavirus (HPV) testing in public emergency departments (EDs) may be a viable strategy to opportunistically screen women who otherwise do not attend for regular Papanicolaou test-based cervical cancer screening. We describe the acceptability of self-sample HPV testing among women presenting to two high-volume, urban EDs that primarily care for the medically underserved. Methods In 2014, a total of 210 women 21 years of age and older were recruited from two public ED waiting areas following a two-stage cluster sampling design. Questionnaire items inquired about demographics, healthcare access and utilization, history of cervical cancer screening, and acceptability of self-sample HPV testing. Descriptive analyses were performed. Results Overall, 34.8% of participants were considered screening non-attendees based on their adherence to the current guidelines for Pap testing every three years. Acceptability of self-sample HPV testing was high, with over 85% of participants reporting that they would be willing to use the test if available. A smaller proportion (58%) was deemed likely to accept self-sample HPV testing in a public ED restroom setting. Primary concerns expressed by women were that the sampling may not be done correctly (64%) and that they may not know how to perform the sampling (39%). Conclusions Opportunistic self-sample HPV testing is acceptable to women seeking care at a high-volume, urban emergency care center. The use of this intervention potentially offers a unique strategy to improve cervical cancer screening among high-risk women who otherwise do not attend for regular screening.