Skip to main content
Top
Published in: BMC Public Health 1/2024

Open Access 01-12-2024 | Human Papillomavirus | Research

Acceptability of self-collected vaginal samples for human papillomavirus testing for primary cervical cancer screening: comparison of face-to-face and online recruitment modes

Authors: Siew-Fei Ngu, Lesley SK Lau, Ching Yin Chan, Hextan YS Ngan, Annie NY Cheung, Karen KL Chan

Published in: BMC Public Health | Issue 1/2024

Login to get access

Abstract

Background

This study aimed to assess the acceptability and attitudes of women towards human papillomavirus (HPV) self-sampling and compare the effectiveness of two delivery modes utilising face-to-face and online website for cervical cancer screening in Hong Kong.

Methods

Women aged 30–65 years were invited to participate by distributing the study information pamphlets at the specialist clinics of a regional acute hospital. Those who were interested in participating were given the option to join directly face-to-face or through an online website. All participants provided informed consent and received self-sampling kits and acceptability questionnaires either immediately (face-to-face) or through the post after registering at the website (online). All participants were requested to collect their own vaginal samples using a swab which was then brushed on a DNA sample storage card and returned to the hospital either in person or by post. The self-collected samples were tested for high-risk HPV using the Sentis HPV assay, a validated isothermal nucleic acid amplification real-time fluorescent detection assay. The primary outcome was the uptake rate of HPV self-sampling.

Results

Of the 1998 women recruited (1200 face-to-face, 798 online), 1377 returned their samples, giving an overall uptake rate of 68.9%. The uptake rate was significantly greater in the face-to-face mode than in the online mode (74.6% vs. 60.4%, p < 0.001). The median age of the participants was 49 years, 43.7% were never or under-screened, and 7.1% had high-risk HPV detected. Overall, 82.1% of the participants reported self-sampling convenient, and 79.3% were not embarrassed when collecting self-samples. However, only 49.8% were confident that they had collected the self-samples correctly. Most (91.1%) of the participants expressed willingness to perform self-sampling again, mostly because it was simple (79.2%) and quick (56.3%).

Conclusions

HPV self-sampling can serve as an alternative primary screening method for cervical cancer in Hong Kong, especially for individuals who have not been adequately screened in the past. Both face-to-face and online website recruitment were associated with high acceptability, emphasising the potential benefits of utilising different platforms and strategies for reaching diverse populations.
Literature
4.
go back to reference Gianino MM, Lenzi J, Bonaudo M, Fantini MP, Siliquini R, Ricciardi W, et al. Organized screening programmes for breast and cervical cancer in 17 EU countries: trajectories of attendance rates. BMC Public Health. 2018;18(1):1236.CrossRefPubMedPubMedCentral Gianino MM, Lenzi J, Bonaudo M, Fantini MP, Siliquini R, Ricciardi W, et al. Organized screening programmes for breast and cervical cancer in 17 EU countries: trajectories of attendance rates. BMC Public Health. 2018;18(1):1236.CrossRefPubMedPubMedCentral
5.
go back to reference Salehiniya H, Momenimovahed Z, Allahqoli L, Momenimovahed S, Alkatout I. Factors related to cervical cancer screening among Asian women. Eur Rev Med Pharmacol Sci. 2021;25(19):6109–22.PubMed Salehiniya H, Momenimovahed Z, Allahqoli L, Momenimovahed S, Alkatout I. Factors related to cervical cancer screening among Asian women. Eur Rev Med Pharmacol Sci. 2021;25(19):6109–22.PubMed
6.
go back to reference Chan KKL, Liu SS, Wei N, Ngu SF, Chu MMY, Tse KY, et al. Primary HPV testing with cytology versus cytology alone in cervical screening-A prospective randomized controlled trial with two rounds of screening in a Chinese population. Int J Cancer. 2020;147(4):1152–62.CrossRefPubMed Chan KKL, Liu SS, Wei N, Ngu SF, Chu MMY, Tse KY, et al. Primary HPV testing with cytology versus cytology alone in cervical screening-A prospective randomized controlled trial with two rounds of screening in a Chinese population. Int J Cancer. 2020;147(4):1152–62.CrossRefPubMed
7.
go back to reference Gilham C, Sargent A, Kitchener HC, Peto J. HPV testing compared with routine cytology in cervical screening: long-term follow-up of ARTISTIC RCT. Health Technol Assess. 2019;23(28):1–44.CrossRefPubMedPubMedCentral Gilham C, Sargent A, Kitchener HC, Peto J. HPV testing compared with routine cytology in cervical screening: long-term follow-up of ARTISTIC RCT. Health Technol Assess. 2019;23(28):1–44.CrossRefPubMedPubMedCentral
8.
go back to reference Ronco G, Dillner J, Elfstrom KM, Tunesi S, Snijders PJ, Arbyn M, et al. Efficacy of HPV-based screening for prevention of invasive cervical cancer: follow-up of four European randomised controlled trials. Lancet. 2014;383(9916):524–32.CrossRefPubMed Ronco G, Dillner J, Elfstrom KM, Tunesi S, Snijders PJ, Arbyn M, et al. Efficacy of HPV-based screening for prevention of invasive cervical cancer: follow-up of four European randomised controlled trials. Lancet. 2014;383(9916):524–32.CrossRefPubMed
9.
go back to reference Rijkaart DC, Berkhof J, Rozendaal L, van Kemenade FJ, Bulkmans NW, Heideman DA, et al. Human papillomavirus testing for the detection of high-grade cervical intraepithelial neoplasia and cancer: final results of the POBASCAM randomised controlled trial. Lancet Oncol. 2012;13(1):78–88.CrossRefPubMed Rijkaart DC, Berkhof J, Rozendaal L, van Kemenade FJ, Bulkmans NW, Heideman DA, et al. Human papillomavirus testing for the detection of high-grade cervical intraepithelial neoplasia and cancer: final results of the POBASCAM randomised controlled trial. Lancet Oncol. 2012;13(1):78–88.CrossRefPubMed
10.
go back to reference Bhatla N, Singhal S. Primary HPV screening for cervical cancer. Best Pract Res Clin Obstet Gynaecol. 2020;65:98–108.CrossRefPubMed Bhatla N, Singhal S. Primary HPV screening for cervical cancer. Best Pract Res Clin Obstet Gynaecol. 2020;65:98–108.CrossRefPubMed
13.
go back to reference Snijders PJ, Verhoef VM, Arbyn M, Ogilvie G, Minozzi S, Banzi R, et al. High-risk HPV testing on self-sampled versus clinician-collected specimens: a review on the clinical accuracy and impact on population attendance in cervical cancer screening. Int J Cancer. 2013;132(10):2223–36.CrossRefPubMed Snijders PJ, Verhoef VM, Arbyn M, Ogilvie G, Minozzi S, Banzi R, et al. High-risk HPV testing on self-sampled versus clinician-collected specimens: a review on the clinical accuracy and impact on population attendance in cervical cancer screening. Int J Cancer. 2013;132(10):2223–36.CrossRefPubMed
14.
go back to reference Hawkes D, Keung MHT, Huang Y, McDermott TL, Romano J, Saville M et al. Self-Collection for Cervical Screening Programs: from research to reality. Cancers (Basel). 2020;12(4). Hawkes D, Keung MHT, Huang Y, McDermott TL, Romano J, Saville M et al. Self-Collection for Cervical Screening Programs: from research to reality. Cancers (Basel). 2020;12(4).
15.
go back to reference Camara H, Zhang Y, Lafferty L, Vallely AJ, Guy R, Kelly-Hanku A. Self-collection for HPV-based cervical screening: a qualitative evidence meta-synthesis. BMC Public Health. 2021;21(1):1503.CrossRefPubMedPubMedCentral Camara H, Zhang Y, Lafferty L, Vallely AJ, Guy R, Kelly-Hanku A. Self-collection for HPV-based cervical screening: a qualitative evidence meta-synthesis. BMC Public Health. 2021;21(1):1503.CrossRefPubMedPubMedCentral
16.
go back to reference Arbyn M, Verdoodt F, Snijders PJ, Verhoef VM, Suonio E, Dillner L, et al. Accuracy of human papillomavirus testing on self-collected versus clinician-collected samples: a meta-analysis. Lancet Oncol. 2014;15(2):172–83.CrossRefPubMed Arbyn M, Verdoodt F, Snijders PJ, Verhoef VM, Suonio E, Dillner L, et al. Accuracy of human papillomavirus testing on self-collected versus clinician-collected samples: a meta-analysis. Lancet Oncol. 2014;15(2):172–83.CrossRefPubMed
17.
go back to reference Arbyn M, Smith SB, Temin S, Sultana F, Castle P, Collaboration on S-S, et al. Detecting cervical precancer and reaching underscreened women by using HPV testing on self samples: updated meta-analyses. BMJ. 2018;363:k4823.CrossRefPubMedPubMedCentral Arbyn M, Smith SB, Temin S, Sultana F, Castle P, Collaboration on S-S, et al. Detecting cervical precancer and reaching underscreened women by using HPV testing on self samples: updated meta-analyses. BMJ. 2018;363:k4823.CrossRefPubMedPubMedCentral
18.
go back to reference Chan AHY, Ngu SF, Lau LSK, Tsun OKL, Ngan HYS, Cheung ANY, et al. Evaluation of an Isothermal amplification HPV assay on self-collected vaginal samples as compared to clinician-collected cervical samples. Diagnostics (Basel). 2023;13:21. Chan AHY, Ngu SF, Lau LSK, Tsun OKL, Ngan HYS, Cheung ANY, et al. Evaluation of an Isothermal amplification HPV assay on self-collected vaginal samples as compared to clinician-collected cervical samples. Diagnostics (Basel). 2023;13:21.
19.
go back to reference Zhang W, Du H, Huang X, Wang C, Duan X, Liu Y, et al. Evaluation of an isothermal amplification HPV detection assay for primary cervical cancer screening. Infect Agent Cancer. 2020;15:65.CrossRefPubMedPubMedCentral Zhang W, Du H, Huang X, Wang C, Duan X, Liu Y, et al. Evaluation of an isothermal amplification HPV detection assay for primary cervical cancer screening. Infect Agent Cancer. 2020;15:65.CrossRefPubMedPubMedCentral
20.
go back to reference Ngu SF, Lau LSK, Li J, Wong GCY, Cheung ANY, Ngan HYS et al. Human papillomavirus self-sampling for primary cervical Cancer screening in under-screened women in Hong Kong during the COVID-19 pandemic. Int J Environ Res Public Health. 2022;19(5). Ngu SF, Lau LSK, Li J, Wong GCY, Cheung ANY, Ngan HYS et al. Human papillomavirus self-sampling for primary cervical Cancer screening in under-screened women in Hong Kong during the COVID-19 pandemic. Int J Environ Res Public Health. 2022;19(5).
21.
go back to reference World Health Organization. WHO cervical cancer elimination initiative: from call to action to global movement. Geneva: World Health Organization; 2023. World Health Organization. WHO cervical cancer elimination initiative: from call to action to global movement. Geneva: World Health Organization; 2023.
22.
go back to reference Woo YL, Khoo SP, Gravitt P, Hawkes D, Rajasuriar R, Saville M. The implementation of a primary HPV self-testing cervical screening program in Malaysia through Program ROSE-Lessons Learnt and moving Forward. Curr Oncol. 2022;29(10):7379–87.CrossRefPubMedPubMedCentral Woo YL, Khoo SP, Gravitt P, Hawkes D, Rajasuriar R, Saville M. The implementation of a primary HPV self-testing cervical screening program in Malaysia through Program ROSE-Lessons Learnt and moving Forward. Curr Oncol. 2022;29(10):7379–87.CrossRefPubMedPubMedCentral
23.
go back to reference Daponte N, Valasoulis G, Michail G, Magaliou I, Daponte AI, Garas A et al. HPV-Based self-sampling in Cervical Cancer Screening: an updated review of the current evidence in the literature. Cancers (Basel). 2023;15(6). Daponte N, Valasoulis G, Michail G, Magaliou I, Daponte AI, Garas A et al. HPV-Based self-sampling in Cervical Cancer Screening: an updated review of the current evidence in the literature. Cancers (Basel). 2023;15(6).
24.
go back to reference Polman NJ, Ebisch RMF, Heideman DAM, Melchers WJG, Bekkers RLM, Molijn AC, et al. Performance of human papillomavirus testing on self-collected versus clinician-collected samples for the detection of cervical intraepithelial neoplasia of grade 2 or worse: a randomised, paired screen-positive, non-inferiority trial. Lancet Oncol. 2019;20(2):229–38.CrossRefPubMed Polman NJ, Ebisch RMF, Heideman DAM, Melchers WJG, Bekkers RLM, Molijn AC, et al. Performance of human papillomavirus testing on self-collected versus clinician-collected samples for the detection of cervical intraepithelial neoplasia of grade 2 or worse: a randomised, paired screen-positive, non-inferiority trial. Lancet Oncol. 2019;20(2):229–38.CrossRefPubMed
25.
go back to reference Nyman MH, Lillsunde Larsson G, Blomberg K, Schroder A. Older women’s perceptions of HPV self-sampling and HPV-sampling performed by a midwife - a phenomenographic study. BMC Public Health. 2024;24(1):211.CrossRefPubMedPubMedCentral Nyman MH, Lillsunde Larsson G, Blomberg K, Schroder A. Older women’s perceptions of HPV self-sampling and HPV-sampling performed by a midwife - a phenomenographic study. BMC Public Health. 2024;24(1):211.CrossRefPubMedPubMedCentral
Metadata
Title
Acceptability of self-collected vaginal samples for human papillomavirus testing for primary cervical cancer screening: comparison of face-to-face and online recruitment modes
Authors
Siew-Fei Ngu
Lesley SK Lau
Ching Yin Chan
Hextan YS Ngan
Annie NY Cheung
Karen KL Chan
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-024-18551-5

Other articles of this Issue 1/2024

BMC Public Health 1/2024 Go to the issue