Gynaecology Division, Department of Paediatrics, Gynaecology and Obstetrics, University Hospitals of Geneva, 1205 Geneva, Switzerland.
School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, 1227 Geneva, Switzerland.
Int J Environ Res Public Health. 2021 Dec 22;19(1):54. doi: 10.3390/ijerph19010054.
Human papillomavirus (HPV) self-sampling (Self-HPV) is a promising strategy to improve cervical cancer screening coverage in low-income countries. However, issues associated with women who prefer conventional HPV clinical-sampling over HPV self-sampling may affect screening participation. To address this issue, our study assessed factors associated with women's preferences related to Self-HPV. This study was embedded in a large clinical trial recruiting women aged 30-49 years in a primary HPV-based study termed "3T-Approach" (for Test-Triage-Treatment), launched in 2018 at Dschang District Hospital, West Cameroon. Participants were invited to perform a Self-HPV. After the sampling and before receiving the results, participants completed a questionnaire about cervical cancer screening and their preferences and perceptions around Self-HPV. The median age of the 2201 participants was 40.6 (IQR 35-45) years. Most (1693 (76.9%)) preferred HPV self-sampling or had no preference for either method, and 508 (23.1%) preferred clinician-sampling. Factors associated with an increased likelihood of reporting a clinician-sampling preference were tertiary educational level (29.4% CI: 25.6-33.6 vs. 14.4% CI: 12.8-16.1) and being an employee with higher grade professional or managerial occupations (5.5% CI: 3.8-7.9 vs. 2.7% CI: 2.0-3.5). The main reported reason for women preferring clinician-sampling was a lack of "self-expertise". Most women (>99%) would agree to repeat HPV self-sampling and would recommend it to their relatives. HPV self-sampling in the cultural context of central Africa was well accepted by participants, but some participants would prefer to undergo clinician sampling. Health systems should support well-educated women to increase self-confidence in using HPV self-sampling.
人乳头瘤病毒（HPV）自我采样（Self-HPV）是提高低收入国家宫颈癌筛查覆盖率的一种有前途的策略。然而，与更喜欢传统 HPV 临床采样而不是 HPV 自我采样的女性相关的问题可能会影响筛查参与度。为了解决这个问题，我们的研究评估了与女性对 Self-HPV 的偏好相关的因素。这项研究是在一个名为“3T 方法”（用于检测-筛查-治疗）的大型临床试验中进行的，该试验于 2018 年在喀麦隆西部的 Dschang 区医院招募了 30-49 岁的女性。参与者被邀请进行 Self-HPV。在采样后但在收到结果之前，参与者完成了一份关于宫颈癌筛查以及他们对 Self-HPV 的偏好和看法的问卷。2201 名参与者的中位年龄为 40.6（IQR 35-45）岁。大多数（1693（76.9%））人更喜欢 HPV 自我采样或对两种方法都没有偏好，508（23.1%）人更喜欢临床医生采样。报告更喜欢临床医生采样的可能性增加的因素包括高等教育水平（29.4%CI：25.6-33.6 比 14.4%CI：12.8-16.1）和更高的专业或管理职位的雇员（5.5%CI：3.8-7.9 比 2.7%CI：2.0-3.5）。女性更喜欢临床医生采样的主要原因是缺乏“自我专业知识”。大多数女性（>99%）会同意重复 HPV 自我采样并将其推荐给亲属。在中非文化背景下，HPV 自我采样得到了参与者的广泛接受，但一些参与者更愿意接受临床医生采样。卫生系统应支持受过良好教育的妇女，增强她们对使用 HPV 自我采样的信心。
