Kimon Chatzistamatiou1, Thomas Vrekoussis2, Athena Tsertanidou3, Theodoros Moysiadis4,5, Evangelia Mouchtaropoulou4, Konstantinos Pasentsis4, Anastasia Kitsou6, Viktoria Moschaki7, Maria Ntoula8, Paraskevi Zempili9, Despina Halatsi10, Theoni Truva11, Vaia Piha12, Georgia Agelena13, Alexandros Daponte14, Polyxeni Vanakara14, Minas Paschopoulos15, Theodoros Stefos15, Vasilis Lymberis16, Emmanuel N Kontomanolis16, Antonis Makrigiannakis2, Efthimios Deligeoroglou17, Theodoros Panoskaltsis17, George Adonakis18, George Michail18, Kostas Stamatopoulos4, Theodoros Agorastos6. 1. 1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece. 2. Department of Obstetrics and Gynecology, University of Crete, Herakleion University Hospital, Herakleion, Greece. 3. 3rd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Hippokratio General Hospital, Thessaloniki, Greece. 4. Institute of Applied Biosciences, Centre for Research & Technology-Hellas, Thessaloniki, Greece. 5. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. 6. 4th Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Hippokratio General Hospital, Thessaloniki, Greece. 7. Department of Neonatology, Hippokratio General Hospital, Midwifery Association of Thessaloniki, Thessaloniki, Greece. 8. Primary Health Care Unit 25th Martiou, Thessaloniki, Midwifery Network Coordinator, 4th Health District, Thessaloniki, Greece. 9. Department of Obstetrics and Gynecology, General Hospital of Komotini, Midwifery Association of Thrace, Komotini, Greece. 10. Department of Obstetrics and Gynecology, Hatzikosta General Hospital of Ioannina, Midwifery Association of Ioannina, Ioannina, Greece. 11. Health Center Palama, Midwifery Association of Larissa, Karditsa, Greece. 12. Department of Obstetrics and Gynecology, General Hospital of Chania, Midwifery Association of Crete, Chania, Greece. 13. Department of Obstetrics and Gynecology, General Hospital of Korinth, Midwifery Association of Nafplion, Korinth, Greece. 14. Department of Obstetrics and Gynecology, University of Thessaly, Larissa University Hospital, Larissa, Greece. 15. Department of Obstetrics and Gynecology, University of Ioannina, Ioannina University Hospital, Ioannina, Greece. 16. Department of Obstetrics and Gynecology, Democritus University of Thrace, Alexandroupolis University Hospital, Alexandroupolis, Greece. 17. 2nd Department of Obstetrics and Gynecology, National Kapodistrian University of Athens, Aretaieion Hospital, Athens, Greece. 18. Department of Obstetrics and Gynecology, University of Patras, Patras University Hospital, Patras, Greece.
Abstract
Background: Human papillomavirus (HPV)-DNA testing combined with self-sampling could increase cervical cancer screening effectiveness, utilizing a sensitive screening modality and an easy sampling method with minimal pain or discomfort. Self-sampling acceptability, though, is pivotal. Materials and Methods: This study is a nested cross-sectional survey within GRECOSELF, a cross-sectional study on HPV-based screening with self-sampling, aiming at investigating self-sampling acceptability among Greek women residing in rural areas, and the factors affecting it. Women between 25 and 60 years old were recruited by midwives participating in a nationwide midwifery network. Participants, after self-sampling, filled out a questionnaire with three sections, one regarding demographic characteristics, a second with questions pertaining to the participants' cervical cancer screening history, and a third with questions regarding the self-sampling process per se. Results: The sample included 13,111 women. Most participants (67.9%), including those screened or not in the past, would prefer self-sampling if assured that the results are not inferior to standard testing. Discomfort or pain during self-sampling was absent or minimal in 97.1% and 96.5% of the cases, respectively, and 74.4% of the women felt adequately confident that they followed the instructions correctly. Women mostly preferred self-sampling at home compared with health care facilities. Pain and discomfort during the procedure, although rare, were significant factors against acceptance. Most of the women reporting a negative impression had a negative experience with conventional sampling in the past. Conclusion: Self-sampling is highly acceptable. Acceptance can be further improved with proper communication of the process and its noninferiority compared with conventional screening.
Background: Human papillomavirus (HPV)-DNA testing combined with self-sampling could increase cervical cancer screening effectiveness, utilizing a sensitive screening modality and an easy sampling method with minimal pain or discomfort. Self-sampling acceptability, though, is pivotal. Materials and Methods: This study is a nested cross-sectional survey within GRECOSELF, a cross-sectional study on HPV-based screening with self-sampling, aiming at investigating self-sampling acceptability among Greek women residing in rural areas, and the factors affecting it. Women between 25 and 60 years old were recruited by midwives participating in a nationwide midwifery network. Participants, after self-sampling, filled out a questionnaire with three sections, one regarding demographic characteristics, a second with questions pertaining to the participants' cervical cancer screening history, and a third with questions regarding the self-sampling process per se. Results: The sample included 13,111 women. Most participants (67.9%), including those screened or not in the past, would prefer self-sampling if assured that the results are not inferior to standard testing. Discomfort or pain during self-sampling was absent or minimal in 97.1% and 96.5% of the cases, respectively, and 74.4% of the women felt adequately confident that they followed the instructions correctly. Women mostly preferred self-sampling at home compared with health care facilities. Pain and discomfort during the procedure, although rare, were significant factors against acceptance. Most of the women reporting a negative impression had a negative experience with conventional sampling in the past. Conclusion: Self-sampling is highly acceptable. Acceptance can be further improved with proper communication of the process and its noninferiority compared with conventional screening.
Entities:
Keywords:
HPV; cervical cancer prevention; human papillomavirus; self-sampling; underserved populations
Authors: Michelle B Shin; Gui Liu; Nelly Mugo; Patricia J Garcia; Darcy W Rao; Cara J Bayer; Linda O Eckert; Leeya F Pinder; Judith N Wasserheit; Ruanne V Barnabas Journal: Front Public Health Date: 2021-07-01