Experiences and Preferences Reported with an At-Home Self-Collection Device Compared with In-Clinic Speculum-Based Cervical Cancer Screening in the United States.

Abstract

Background: Vaginal self-collection offers an effective option for cervical cancer (CC) screening that can improve screening experiences and engagement.

Objective: This article presents data from a multi-center pilot study (n = 185) across the United States, evaluating experiences and preferences reported with an at-home self-collection device compared with clinician-collected screening using a speculum. The device is designed specifically for at-home self-collection and optimized for performance and usability, where collected samples are tested for high-risk human papillomavirus (hrHPV) using the Roche cobas HPV test. In an earlier report, self-collected samples using this device showed high agreement for hrHPV detection when compared with clinician-collection with a speculum and cervical brush.

Study design: Participants were screened with a self-collection device and a clinician-collection. They provided feedback about their experiences via usability and preference surveys.

Results: Significantly more participants reported pain (p < 0.001), discomfort (p < 0.001), embarrassment (p < 0.001), and nervousness (p < 0.001) during clinician-collection compared with self-collection. In contrast, being at-ease (p < 0.001) and in-control (p < 0.001) were reported significantly more during self-collection. Similar patterns held across demographic groups relevant to CC screening engagement and related risk (i.e., sexual orientation, menopause status, income, and prior HPV diagnosis). Almost all (94% [156/166]) felt confident using the at-home self-collection device if they knew the results would be equivalent to clinician-collection. The device demonstrated wide usability, with 96% (163/170) successfully self-collecting using only the device's provided instructions.

Conclusion: By improving screening experiences and accessibility, at-home self-collection can increase screening participation and accelerate progress toward eliminating CC as a public health concern in the United States.