Motivations and Preferences for Self-Sampled Human Papillomavirus Testing Among Average-and High-Risk Patients: An Exploratory Analysis.

Abstract

Objectives: Cervical cancer screening rates fall below national goals. At-home self-sampled tests for human papillomavirus (HPV) may improve screening rates. This study assesses the acceptability of self-sampled HPV testing with respect to motivating factors and preference among average-risk patients (undergoing routine screening) and high-risk patients (receiving follow-up care after abnormal screening results).

Materials and methods: This cross-sectional study sample consisted of 46 participants (female, ages 30-65), including average-risk (n = 35) and high-risk (n = 11) patients, who had already received clinician-collected cervical cancer screening. Participants completed a self-sampled HPV test and a survey. Motivators included cervical cancer screening facilitators, sexual history, health care factors, and feelings during self-sampled test. We analyzed the relationships between these constructs and test modality preference for their next cervical cancer screening (i.e., self-sampled HPV testing at home vs. other preference).

Results: Few participants experienced negative feelings during self-sampled HPV testing (uncomfortable: 20%; anxious: 22%; and unpleasant: 15%). Overall, 57% of participants would prefer to complete a self-sampled HPV test at home for their next cervical cancer screening compared with other test options. Test modality preference for their next cervical cancer screening did not differ for average- versus high-risk patients, and it did not vary by any of the motivating factors we assessed (all p > 0.05).

Conclusions: Acceptability of self-sampled HPV testing at home is high, with little difference in attitudes observed across patient characteristics. These findings demonstrate that self-sampled HPV testing may be an effective tool for increasing cervical cancer screening, even among high-risk patients who have previously had abnormal screening results.