Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.
School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA.
Sex Transm Infect. 2018 Mar;94(2):131-137. doi: 10.1136/sextrans-2017-053235. Epub 2017 Sep 2.
Self-collection of cervico-vaginal samples for human papillomavirus (HPV) testing has the potential to make cervical cancer screening more accessible to underscreened women. We evaluated the acceptability and ease of use of home-based HPV self-collection within a diverse population of low-income, infrequently screened women.
Participants were low-income women from North Carolina who had not received Pap testing in 4 or more years. Eligible women received a self-collection kit containing instructions and a brush for home-based sample collection. A total of 227 women returned a self-collected sample by mail and completed a questionnaire to assess their experiences with HPV self-collection. We described acceptability measures and used logistic regression to identify predictors of overall positive thoughts about the self-collection experience.
Nearly all women were willing to perform HPV self-collection again (98%) and were comfortable receiving the self-collection kit in the mail (99%). Overall, 81% of participants reported positive thoughts about home-based self-collection. Women with at least some college education and those who were divorced, separated or widowed were more likely to report overall positive thoughts. Aspects of self-collection that participants most commonly reported liking included convenience (53%), ease of use (32%) and privacy (23%). The most frequently reported difficulties included uncertainty that the self-collection was done correctly (16%) and difficulty inserting the self-collection brush (16%).
Home-based self-collection for HPV was a highly acceptable screening method among low-income, underscreened women and holds the promise to increase access to cervical cancer screening in this high-risk population.
自行采集宫颈阴道样本进行人乳头瘤病毒（HPV）检测，有可能使宫颈癌筛查更容易惠及筛查不足的女性。我们评估了在收入较低、筛查频率较低的多样化人群中，基于家庭的 HPV 自我采集的可接受性和易用性。
参与者为北卡罗来纳州的低收入女性，她们已经有 4 年以上没有接受过巴氏涂片检查。符合条件的女性收到了一个包含说明和刷子的自我采集套件，用于在家中采集样本。共有 227 名女性通过邮件寄回了自行采集的样本，并完成了一份问卷，以评估她们对 HPV 自我采集的体验。我们描述了可接受性措施，并使用逻辑回归来确定对自我采集体验的总体积极想法的预测因素。
几乎所有女性都愿意再次进行 HPV 自我采集（98%），并且愿意通过邮件接收自我采集套件（99%）。总体而言，81%的参与者对基于家庭的自我采集有积极的想法。接受过一定程度大学教育的女性以及离婚、分居或丧偶的女性更有可能报告总体积极的想法。参与者最常报告喜欢的自我采集方面包括方便（53%）、易用性（32%）和隐私（23%）。最常报告的困难包括对自我采集是否正确的不确定性（16%）和插入自我采集刷子的困难（16%）。
基于家庭的 HPV 自我采集是一种在低收入、筛查不足的女性中高度可接受的筛查方法，有望增加该高危人群接受宫颈癌筛查的机会。
