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Self-collection for HPV-based cervical screening: a qualitative evidence meta-synthesis
Hawa Camara1, Ye Zhang2, Lise Lafferty2,3
1Kirby Institute for Infection and Immunity in Society, UNSW Sydney, Level 6, Wallace Wurth Building, Sydney, NSW, 2052, Australia. hcamara@kirby.unsw.edu.au.
BMC Public Health
|August 5, 2021
Summary
Self-collection for human papillomavirus (HPV) testing offers a promising approach to cervical cancer screening, particularly in low-resource settings. Addressing individual, social, and health system factors can improve its acceptability and feasibility globally.
Area of Science:
- Oncology
- Public Health
- Gynecology
Background:
- Cervical cancer is a major global health issue, disproportionately affecting women in low and middle-income countries (LMICs).
- Human papillomavirus (HPV) testing via self-collection is a novel screening development.
- This review synthesizes qualitative research on HPV self-collection for cervical screening.
Purpose of the Study:
- To synthesize qualitative research on self-collection for HPV-based cervical screening.
- To identify strategies for increasing the acceptability and feasibility of HPV self-collection.
- To reduce the global burden of cervical cancer.
Main Methods:
- A systematic review of qualitative studies published between 1986 and 2020.
- Searched 10 databases for studies on women's, healthcare workers', and policymakers' perspectives.
- Utilized the Socio-Ecological Model (SEM) for thematic synthesis of 31 included studies.
Main Results:
- 10 sub-themes were identified and categorized under SEM constructs: intrapersonal, interpersonal, and health systems/public policy.
- Key intrapersonal themes include self-efficacy and perceived value of self-collection.
- Health system themes highlight the need for access, culturally sensitive programs, and continuum of care.
Conclusions:
- Qualitative evidence highlights socio-cultural and structural barriers and facilitators to HPV self-collection.
- Implementing identified strategies can enhance acceptability and feasibility of HPV-based screening.
- Improved access to effective and sustainable cervical screening services for women worldwide is achievable.
