Evaluation of the Impact of Human Papillomavirus DNA Self-sampling on the Uptake of Cervical Cancer Screening

Cancer Nurs. 2016 Jan-Feb;39(1):E1-E11. doi: 10.1097/NCC.0000000000000241.

Abstract

Background: The rate of uptake of the Papanicolaou (Pap) smear is generally low. Its causal relationship with human papillomavirus (HPV) DNA allows HPV DNA self-sampling to be used as an alternative screening tool for cervical cancer.

Objectives: This study explored the acceptability of HPV DNA self-sampling and its impact on the rate of compliance with cervical cancer screening.

Methods: A crossover randomized clinical trial was conducted in community-based clinics. Participants were allocated to 1 of the following 2 arms: arm 1: self-sampling before a Pap smear; and arm 2: a Pap smear before self-sampling. After completing the 2 screening methods, participants in each arm took part in face-to-face interviews using standardized, structured questionnaire.

Results: The participants accepted both self-sampling (7.7/10) and a Pap smear (7.8/10) for cervical cancer screening. However, participants without previous experience of Pap smears or who had more than 2 sexual partners preferred self-sampling (P < .05). The participants expressed overall positive feelings toward self-sampling, and there was good agreement in HPV detection between the 2 screening methods (κ = 0.65). We estimate that the introduction of HPV DNA self-sampling could increase the future rate of uptake of cervical cancer screening by 6.5% and would entail lower costs.

Conclusion: Human papillomavirus DNA self-sampling could be an alternative screening method to increase the coverage of cervical cancer screening.

Implications for practice: Human papillomavirus DNA self-sampling could overcome the barriers raised by Pap smears and enhance the coverage of cervical cancer screening. Promotional publicity and education are essential.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cross-Over Studies
  • DNA, Viral / analysis
  • Early Detection of Cancer / methods
  • Early Detection of Cancer / statistics & numerical data*
  • Female
  • Human Papillomavirus DNA Tests*
  • Humans
  • Middle Aged
  • Papanicolaou Test / statistics & numerical data*
  • Papillomaviridae / genetics
  • Papillomaviridae / isolation & purification
  • Papillomavirus Infections / diagnosis
  • Self Care
  • Uterine Cervical Neoplasms / prevention & control*

Substances

  • DNA, Viral