Khoo Su Pei, Bouniu Joanne Johnny, Sivaram Lavanya, Hawkes David, Tan Peng Chiong, Saville Marion, Woo Yin Ling
Department of Obstetrics and Gynaecology, University of Malaya Medical Centre, Kuala Lumpur, Malaysia.
Australian Centre for the Prevention of Cervical Cancer, Carlton, Victoria, Australia.
PLOS Glob Public Health. 2025 Sep 2;5(9):e0005149. doi: 10.1371/journal.pgph.0005149. eCollection 2025.
This study evaluated the feasibility, safety, and acceptability of self-collected vaginal samples for human papillomavirus (HPV) testing among pregnant women in an urban teaching hospital in Malaysia. This cross-sectional study recruited pregnant women aged 30 years and above who attended antenatal care at the University of Malaya Medical Centre. Participants self-collected vaginal samples using FLOQSwabs and completed pre- and post-sampling questionnaires assessing acceptability. Samples were analysed using the Roche cobas 4800 system. HPV-positive participants were referred for postpartum colposcopy. A total of 2,256 eligible pregnant women were invited to participate in the study and 1,603 of them consented to participate, representing 71.1% of uptake. Of the 1,603 participants, 99.6% (1,596) agreed to self-collect, with 98.6% successfully completing the procedure. More than 80% of participants responded positively to acceptability indicators after self-collection procedure, including overall feeling, ease of performance, convenience, and confidence in collecting an accurate sample. The HPV prevalence recorded in the study population was 6.3%, with most infections involving non-HPV16/18 types. No major complications associated with the sampling procedure were reported, and 99.0% of participants expressed willingness to use self-collection for future cervical screening. Self-collection for HPV-based cervical screening during pregnancy is highly acceptable, safe, and feasible, with performance comparable to the general population. Integrating self-collection into antenatal care can enhance cervical cancer screening rates among under-screened populations, contributing to global elimination goals.
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