Barriers to Acceptance of Self-Sampling for Human Papillomavirus Across Ethnolinguistic Groups of Women (Qualitative Research) (Report‪)‬

In 2002, there were an estimated 490,000 new cases of cervical cancer worldwide. (1) This incidence rate varies greatly across the world, with rates in some areas of the developing world six times higher than in North America. Even in developed countries with screening programs, approximately one third of women do not participate regularly or ever in Papanicolaou (Pap) smear screening, with women of lower socio-economic status and immigrants being particularly under-represented in screening. (2-4) One common barrier to screening is the need for pelvic examination with speculum insertion. (5) Self-obtained vaginal sampling for human papillomavirus (HPV) testing has been investigated as an alternative to physician-obtained Pap smears for cervical cancer prevention. (6,7) Studies of vaginal self-sampling perceptions have mainly been conducted in clinics among women attending for cervical screening or treatment, using quantitative questionnaires; these studies provide limited insight into understanding barriers to and enablers for screening. Several studies have found that women who have experienced both physician Pap testing and vaginal self-sampling reported a preference for self-sampling or stated no preference. (8,9-11) However, results from studies on the acceptability of self-sampling may not be generalizable to all ethnic groups or to women who have not yet performed self-sampling. (12)