Reach and effectiveness of an HPV self-sampling intervention for cervical screening amongst under- or never-screened women in Toronto, Ontario Canada

BMC Women's Health

Research

Mandana Vahabi¹  Kimberly Devotta²  Aisha Lofters³  Vijayshree Prakash⁴ 

[1] Daphne Cockwell School of Nursing, Toronto Metropolitan University (Formerly Ryerson University), M5B 1Z5, Toronto, ON, Canada;MAP Centre for Urban Health Solutions, St. Michael’s Hospital, M5B 1T8, Toronto, ON, Canada;Dalla Lana School of Public Health, University of Toronto, M5T 3M7, Toronto, ON, Canada;Peter Gilgan Centre for Women’s Cancers, Women’s College Hospital, M5S 1B2, Toronto, ON, Canada;MAP Centre for Urban Health Solutions, St. Michael’s Hospital, M5B 1T8, Toronto, ON, Canada;Dalla Lana School of Public Health, University of Toronto, M5T 3M7, Toronto, ON, Canada;Peter Gilgan Centre for Women’s Cancers, Women’s College Hospital, M5S 1B2, Toronto, ON, Canada;Department of Family and Community Medicine, University of Toronto, M5G 1V7, Toronto, ON, Canada;WECAN Research Project, Toronto Metropolitan University (Formerly Ryerson University), M5B 1Z5, Toronto, ON, Canada;

关键词: Cervical cancer;    Cervical screening;    HPV self-sampling;    Community champions;    Health equity;    Immigrant health;    RE-AIM;   

DOI  :  10.1186/s12905-023-02174-w

 received in 2022-05-10, accepted in 2023-01-12,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundCervical cancer is almost entirely preventable with appropriate and timely screening. In Ontario, Canada, South Asian, Middle Eastern and North African women have some of the lowest rates of screening and a suggested higher burden of cervical cancer. With increasing international evidence and adoption of HPV testing, many screening programs are making the move away from Pap tests and towards HPV testing with the option of HPV self-sampling seeming promising for under- or never-screened (UNS) women. Our study aimed to understand the uptake and acceptability of an HPV self-sampling intervention amongst these disproportionately UNS women in Peel region and surrounding areas in Ontario.MethodsA community -based mixed methods approach guided by the RE-AIM framework was used to recruit approximately 100 UNS racialized immigrant women aged 30–69, during the period of June 2018 to December 2019. The main recruitment strategy included community champions (i.e. trusted female members of communities) to engage people in our selected areas in Peel Region. Participants completed a study questionnaire about their knowledge, attitudes and practices around cervical cancer screening, self-selected whether to use the HPV self-sampling device and completed follow-up questions either about their experience with self-sampling or going to get a Pap test.ResultsIn total, 108 women participated in the study, with 69 opting to do self-sampling and 39 not. The majority of women followed through and used the device (n = 61) and found it ‘user friendly.’ The experience of some participants suggests that clearer instructions and/or more support once at home is needed. Survey and follow-up data suggest that privacy and comfort are common barriers for UNS women, and that self-sampling begins to address these concerns. Across both groups addressing misinformation and misconceptions is needed to convince some UNS women to be screened. Family, friends and peers also seemed to play a role in the decision-making process.ConclusionsHPV self-sampling is viewed as an acceptable alternative to a Pap test for cervical screening, by some but not all UNS women. This method begins to address some of the barriers that often prevent women from being screened and is already being offered in some jurisdictions as an alternative to clinical cervical cancer screening.

【 授权许可】

CC BY   
© The Author(s) 2023