Rural women choose self-sampling over a pelvic exam for cervical cancer screening: a mixed-method study

Area of Science:

• Public Health
• Gynecology
• Preventive Medicine

Background:

• Cervical cancer screening barriers are higher in rural US populations.
• Understanding these barriers is crucial for improving screening rates.
• This study focuses on rural Michigan residents.

Purpose of the Study:

• Compare perceptions of vaginal self-sampling versus pelvic exams for cervical cancer screening.
• Investigate how perceptions vary by participant beliefs and physician characteristics.
• Explore potential remedies for screening barriers in under-screened rural populations.

Main Methods:

• Mixed-methods study comparing vaginal self-sampling (HerSwab) with pelvic exam experiences.
• Quantitative surveys based on Health Information National Trends Survey (HINTS) modules.
• Qualitative interviews using Likert scales and the Theoretical Domains Framework (TDF).
• Thematic analysis of interviews and descriptive statistics for survey data.

Main Results:

• Forty rural white women participated.
• Self-sampling received significantly higher positive ratings and fewer negative ratings than pelvic exams.
• Qualitative themes included preference for self-sampling, reduced physical/emotional discomfort, convenience, and empowerment.

Conclusions:

• Negative perceptions of pelvic exams may deter screening participation.
• Vaginal self-sampling presents a preferred, convenient, and empowering alternative for cervical cancer screening.
• This method could increase screening uptake in rural populations.