Acceptability of self-sample human papillomavirus testing among medically underserved women visiting the emergency department

Gynecol Oncol. 2015 Aug;138(2):317-22. doi: 10.1016/j.ygyno.2015.05.028. Epub 2015 May 28.

Abstract

Objective: Self-sample human papillomavirus (HPV) testing in public emergency departments (EDs) may be a viable strategy to opportunistically screen women who otherwise do not attend for regular Papanicolaou test-based cervical cancer screening. We describe the acceptability of self-sample HPV testing among women presenting to two high-volume, urban EDs that primarily care for the medically underserved.

Methods: In 2014, a total of 210 women 21 years of age and older were recruited from two public ED waiting areas following a two-stage cluster sampling design. Questionnaire items inquired about demographics, healthcare access and utilization, history of cervical cancer screening, and acceptability of self-sample HPV testing. Descriptive analyses were performed.

Results: Overall, 34.8% of participants were considered screening non-attendees based on their adherence to the current guidelines for Pap testing every three years. Acceptability of self-sample HPV testing was high, with over 85% of participants reporting that they would be willing to use the test if available. A smaller proportion (58%) was deemed likely to accept self-sample HPV testing in a public ED restroom setting. Primary concerns expressed by women were that the sampling may not be done correctly (64%) and that they may not know how to perform the sampling (39%).

Conclusions: Opportunistic self-sample HPV testing is acceptable to women seeking care at a high-volume, urban emergency care center. The use of this intervention potentially offers a unique strategy to improve cervical cancer screening among high-risk women who otherwise do not attend for regular screening.

Keywords: Cervical cancer screening; Emergency departments; Human papillomavirus; Self-testing.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Black or African American
  • Emergency Service, Hospital
  • Female
  • Hispanic or Latino
  • Humans
  • Medically Underserved Area*
  • Papillomaviridae / isolation & purification*
  • Papillomavirus Infections / diagnosis*
  • Papillomavirus Infections / ethnology
  • Patient Acceptance of Health Care*
  • Self-Examination / methods*
  • Self-Examination / standards*
  • Specimen Handling / methods
  • Specimen Handling / psychology
  • Specimen Handling / standards
  • White People