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Evaluating The Feasibility and Acceptability of Cervical Cancer Screening in an Urban Slum Community by HPV
Nilanchali Singh1, Shivangi Mangal1, Pranay Tanwar2
1Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, New Delhi, India.
Introduction:
HPV testing is the most sensitive method of secondary cervical cancer prevention and the preferred method recommended by the World Health Organization. To increase cervical cancer screening, self-sampling has been introduced, which has shown significant results in improving access and simplifying screening for large and remote populations in low- and middle-income countries. This study aims to evaluate the feasibility and acceptability of HPV self-sampling in an urban slum community using tele-counselling, which is a niche population for HPV positivity and HPV-related diseases.
Methods:
This study is a community-based, prospective, single-arm design. Women were counselled telephonically about the methods of self-sampling, and HPV self-sampling kits were couriered to them. The collected kits were returned via courier and tested at the study site. In the case of a positive test result, the individual was linked to treatment at the study center. Test positives were offered either a 'see and treat' approach or colposcopy triage.
Results:
In the community, 982 women were enrolled in the study, but only 600 (61%) women consented to screening by HPV self-sampling. Ninety-six (15.6%) out of 600 women tested positive for Hr-HPV. Age, educational status, locality, occupation, menopausal status, and smoking status were similar in both screen-negative and screen-positive groups. Among the 600 women, 570 (95%) found it easy to take a self-sample, and 588 (98%) were satisfied with the overall experience. CIN I was found in 6 (6.4%), and CIN II was found in 4 (4.3%) cases. LEEP was performed in patients diagnosed with CIN II.
Conclusions:
HPV self-sampling is an acceptable method of cervical cancer screening, with an acceptance rate of 61% among urban slum women. It demonstrates that HPV self-sampling is feasible when supported by tele-counselling.
