HPV Self-sampling Among Women in the United States: Preferences for Implementation

Overview

Journal Cancer Causes Control

Specialties Oncology
Public Health

Date 2023 Aug 26

PMID 37633857

Authors

Ashvita Garg

Annalynn M Galvin

Stacey B Griner

Zeev Rosberger

Ellen M Daley

Erika L Thompson

Affiliations

Soon will be listed here.

Abstract

Purpose: With the inclusion of primary HPV testing in 2018 U.S. Preventive Services Taskforce guidelines, at-home HPV self-sampling may provide a future option for cervical cancer screening, especially among hard-to-reach populations in the U.S. This study evaluated the association of implementation preferences with the willingness of at-home HPV self-sampling.

Methods: We conducted a cross-sectional study in 2018 among U.S. women ages 30-65 years, without a hysterectomy (n = 812). The outcome was willingness to have at-home HPV self-sampling (yes/no). Primary predictor variables (i.e., information source, methods of payment, methods of sending or receiving self-sampling kits) measured self-sampling implementation preferences. Adjusted logistic regression identified associations with willingness to have at-home HPV self-sampling.

Results: Participants who preferred receiving information from healthcare providers (OR = 2.64; 95% CI 1.54,4.52) or from media or other sources (OR = 2.30; 95% CI 1.51,3.48) had higher HPV self-sampling willingness than participants who did not prefer those sources. Participants who did not want to pay for self-sampling (OR = 0.21; 95% CI 0.14,0.32) or did not know if they would pay for self-sampling (OR = 0.35; 95% CI 0.22,0.54) had lower odds of HPV self-sampling willingness compared to participants willing to pay. Participants who did not know which method they preferred for receiving a self-sampling kit (OR = 0.15, 95% CI 0.07,0.31) or preferred delivering the sample to the lab themselves (OR = 0.59; 95% CI 0.36,0.96) had lower odds for self-sampling willingness compared to participants who preferred the mail.

Conclusion: Understanding the preferences of women regarding the implementation of HPV self-sampling can improve uptake in cervical cancer screening, especially among hard-to-reach populations.

References

Lewis R, Laprise J, Gargano J, Unger E, Querec T, Chesson H . Estimated Prevalence and Incidence of Disease-Associated Human Papillomavirus Types Among 15- to 59-Year-Olds in the United States. Sex Transm Dis. 2021; 48(4):273-277. PMC: 10037549. DOI: 10.1097/OLQ.0000000000001356. View

Markowitz L, Dunne E, Saraiya M, Chesson H, Curtis C, Gee J . Human papillomavirus vaccination: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2014; 63(RR-05):1-30. View

Burger E, Smith M, Killen J, Sy S, Simms K, Canfell K . Projected time to elimination of cervical cancer in the USA: a comparative modelling study. Lancet Public Health. 2020; 5(4):e213-e222. PMC: 8715100. DOI: 10.1016/S2468-2667(20)30006-2. View

Sherman M, Wang S, Carreon J, Devesa S . Mortality trends for cervical squamous and adenocarcinoma in the United States. Relation to incidence and survival. Cancer. 2005; 103(6):1258-64. DOI: 10.1002/cncr.20877. View

Melnikow J, Henderson J, Burda B, Senger C, Durbin S, Weyrich M . Screening for Cervical Cancer With High-Risk Human Papillomavirus Testing: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2018; 320(7):687-705. DOI: 10.1001/jama.2018.10400. View

Curry S, Krist A, Owens D, Barry M, Caughey A, Davidson K . Screening for Cervical Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2018; 320(7):674-686. DOI: 10.1001/jama.2018.10897. View

Arbyn M, Castle P . Offering Self-Sampling Kits for HPV Testing to Reach Women Who Do Not Attend in the Regular Cervical Cancer Screening Program. Cancer Epidemiol Biomarkers Prev. 2015; 24(5):769-72. DOI: 10.1158/1055-9965.EPI-14-1417. View

Smith M, Lew J, Simms K, Canfell K . Impact of HPV sample self-collection for underscreened women in the renewed Cervical Screening Program. Med J Aust. 2016; 204(5):1941e-7. DOI: 10.5694/mja15.00912. View

Snijders P, Verhoef V, Arbyn M, Ogilvie G, Minozzi S, Banzi R . High-risk HPV testing on self-sampled versus clinician-collected specimens: a review on the clinical accuracy and impact on population attendance in cervical cancer screening. Int J Cancer. 2012; 132(10):2223-36. DOI: 10.1002/ijc.27790. View

10.

Nelson E, Maynard B, Loux T, Fatla J, Gordon R, Arnold L . The acceptability of self-sampled screening for HPV DNA: a systematic review and meta-analysis. Sex Transm Infect. 2017; 93(1):56-61. DOI: 10.1136/sextrans-2016-052609. View

11.

Fedewa S, Star J, Bandi P, Minihan A, Han X, Yabroff K . Changes in Cancer Screening in the US During the COVID-19 Pandemic. JAMA Netw Open. 2022; 5(6):e2215490. PMC: 9166223. DOI: 10.1001/jamanetworkopen.2022.15490. View

12.

Wentzensen N, Clarke M, Perkins R . Impact of COVID-19 on cervical cancer screening: Challenges and opportunities to improving resilience and reduce disparities. Prev Med. 2021; 151:106596. PMC: 8241689. DOI: 10.1016/j.ypmed.2021.106596. View

13.

Bishop E, Katz M, Reiter P . Acceptability of Human Papillomavirus Self-Sampling Among a National Sample of Women in the United States. Biores Open Access. 2019; 8(1):65-73. PMC: 6497327. DOI: 10.1089/biores.2018.0040. View

14.

Jayasinghe Y, Rangiah C, Gorelik A, Ogilvie G, Wark J, Hartley S . Primary HPV DNA based cervical cancer screening at 25 years: Views of young Australian women aged 16-28 years. J Clin Virol. 2015; 76 Suppl 1:S74-S80. DOI: 10.1016/j.jcv.2015.10.026. View

15.

Mao C, Kulasingam S, Whitham H, Hawes S, Lin J, Kiviat N . Clinician and Patient Acceptability of Self-Collected Human Papillomavirus Testing for Cervical Cancer Screening. J Womens Health (Larchmt). 2017; 26(6):609-615. PMC: 5512311. DOI: 10.1089/jwh.2016.5965. View

16.

Kobetz E, Seay J, Koru-Sengul T, Baeker Bispo J, Trevil D, Gonzalez M . A randomized trial of mailed HPV self-sampling for cervical cancer screening among ethnic minority women in South Florida. Cancer Causes Control. 2018; 29(9):793-801. PMC: 6329676. DOI: 10.1007/s10552-018-1055-7. View

17.

Flowers P, Vojt G, Pothoulaki M, Mapp F, Woode Owusu M, Estcourt C . Understanding the barriers and facilitators to using self-sampling packs for sexually transmitted infections and blood-borne viruses: Thematic analyses for intervention optimization. Br J Health Psychol. 2022; 28(1):156-173. PMC: 10086833. DOI: 10.1111/bjhp.12617. View

18.

Thompson E, Galvin A, Daley E, Tatar O, Zimet G, Rosberger Z . Recent changes in cervical cancer screening guidelines: U.S. women's willingness for HPV testing instead of Pap testing. Prev Med. 2019; 130:105928. DOI: 10.1016/j.ypmed.2019.105928. View

19.

Adegboyega A, Wiggins A, Williams L, Dignan M . HPV Testing Behaviors and Willingness to Use HPV Self-sampling at Home Among African American (AA) and Sub-Saharan African Immigrant (SAI) Women. J Racial Ethn Health Disparities. 2021; 9(6):2485-2494. PMC: 10060062. DOI: 10.1007/s40615-021-01184-4. View

20.

Kepka D, Rutkoski H, Pappas L, Tay D, Winkler J, Dixon B . US oral health students' willingness to train and administer the HPV vaccine in dental practices. Prev Med Rep. 2019; 15:100957. PMC: 6661379. DOI: 10.1016/j.pmedr.2019.100957. View