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Patient acceptance of HPV self-sampling approach for cervical cancer screening: evidence from a pilot study in
Mereke Rakhmanova1, Yesbolat Sakko2, Assem Suleimenova3
1School of Medicine, Nazarbayev University, Astana, Kazakhstan.
Background:
Cervical cancer remains a major global health burden, particularly in low- and middle-income countries. In Kazakhstan, cervical cancer incidence is rising, despite an established cytology-based screening program. Self-sampling for human papillomavirus (HPV) genotyping is suggested as a promising strategy to improve screening participation, yet it has not been evaluated in Kazakhstan. Thus, this study aims to perform a preliminary assessment of self-sampling approach acceptance among Kazakhstani women.
Methods:
A cross-sectional study was conducted among women attending outpatient clinics in large cities in Kazakhstan between August 2024 and June 2025. Participants used both the Evalyn Brush and BGI Sentis self-sampling kits and completed structured questionnaires assessing knowledge, perceptions, ease of use, discomfort, confidence and willingness to recommend. Descriptive and bivariate statistics were performed to evaluate associations with acceptance and usability.
Results:
A total of 124 women were included in this pilot study, with a median age of 34.5 years (IQR: 27.5-44.0). Only 28.2% of respondents preferred self-sampling for their next screening, whereas 62.1% preferred gynaecologist-collected samples. The Evalyn Brush demonstrated higher ease of use (93.5%) compared to the BGI kit (45.2%). Confidence in correct self-collection was also higher for the Evalyn Brush (85.4% vs. 67.7%). Women who believed that home-based self-sampling is easier than Pap-smear were significantly more likely to prefer self-sampling for future screening (p < 0.001). Education level was associated with HPV knowledge but not with acceptance.
Conclusion:
Self-sampling is acceptable for a proportion of Kazakhstani women, with the Evalyn Brush showing greater comfort, ease and confidence, indicating that device selection is critical for successful implementation. The findings support further large-scale evaluation that will guide improvements to Kazakhstan's cervical cancer screening programme. A nationwide study is required for a more precise assessment of the self-sampling approach acceptance and the strategy's feasibility.
