Andrew-Bassey Uduak Ima, Oke Deborah Olamiposi, Okunlola Michael A, Morhason-Bello Imran
Pan African University Life and Earth Sciences Institute (Including Health and Agriculture), University of Ibadan, Ibadan, Nigeria.
Centre for Medical Informatics and Professional Development, Ibadan, Nigeria.
PLOS Glob Public Health. 2025 May 23;5(5):e0004641. doi: 10.1371/journal.pgph.0004641. eCollection 2025.
The burden of cervical cancer (CC) continues to rise in Sub-Saharan Africa (SSA) while some high-income countries are approaching elimination targets. Self-sampling for Human Papillomavirus (HPV) test for CC screening is increasingly used globally to accelerate wide coverage but some have reported barriers against its use. This scoping review explored published literature on the perception and attitude of women on the methods for collecting cervicovaginal samples for HPV testing for CC in SSA. This involves a review of electronic databases including Pubmed, Cochrane, Google Scholar, and African Journal Online. The review was limited to published English articles between 2013-2023 using the Arksey and O'Malley framework. Included studies were articles that used perception, attitude, perspective, or acceptability as primary or secondary outcome variables. Of the 137 articles, 131 articles were excluded due to duplicates and ineligibility. Six studies reported that women perceived self-sampling to provide better privacy and comfort, five studies reported that self-sampling was an easier procedure, five studies reported self-sampling was less painful, four reported that self-samples caused lesser embarrassment, three studies reported that women were willing to self-sample, and five studies reported it to be associated with better confidentiality than clinician sampling. Six studies reported that women perceived that the biological samples collected by the clinicians were more reliable compared to self-collected samples. Three studies showed that women preferred self-sampling in a private place in the hospital because they can seek reassurance from clinicians, and reduce the risk of financial burden associated with multiple visitations to the hospital. This shows that self-sampling is preferred relative to clinician-initiated collection of samples for HPV-based CC screening. It is important to emphasize increased sensitization on the reliability of self-sampling before asking the women to self-collect cervicovaginal samples.
在撒哈拉以南非洲地区（SSA），宫颈癌（CC）的负担持续上升，而一些高收入国家正接近消除目标。用于宫颈癌筛查的人乳头瘤病毒（HPV）检测的自我采样在全球范围内越来越多地被使用，以加速广泛覆盖，但一些人报告了其使用存在障碍。本范围综述探讨了关于撒哈拉以南非洲地区女性对用于宫颈癌HPV检测的宫颈阴道样本采集方法的认知和态度的已发表文献。这涉及对包括PubMed、Cochrane、谷歌学术和非洲在线期刊在内的电子数据库进行综述。该综述限于2013年至2023年期间使用阿克西和奥马利框架发表的英文文章。纳入的研究是将认知、态度、观点或可接受性作为主要或次要结局变量的文章。在137篇文章中，由于重复和不符合条件，排除了131篇文章。六项研究报告称，女性认为自我采样能提供更好的隐私和舒适度，五项研究报告称自我采样是一个更简单的程序，五项研究报告称自我采样疼痛较轻，四项报告称自我采样造成的尴尬较少，三项研究报告称女性愿意进行自我采样，五项研究报告称与临床医生采样相比，自我采样具有更好的保密性。六项研究报告称，女性认为临床医生采集的生物样本比自我采集的样本更可靠。三项研究表明，女性更喜欢在医院的私人场所进行自我采样，因为她们可以从临床医生那里获得安心，并降低因多次前往医院而产生经济负担的风险。这表明，相对于临床医生发起的基于HPV的宫颈癌筛查样本采集，自我采样更受青睐。在要求女性自行采集宫颈阴道样本之前，强调提高对自我采样可靠性的认识非常重要。
