Acceptability of Home-Based Urine Self-Collection for Cervical Cancer Screening Among Women Receiving Care at the Arab Community Center for Economic and Social Services in Michigan

Abstract

Background: Michigan's Middle Eastern-North African (MENA) community is an essential and growing part of the state's population. However, MENA individuals are underrepresented in the research literature due to a lack of recognized demographic categorization. Prior work shows that MENA women face barriers to traditional clinician-directed cervical cancer screening. This study aims to capture the perspectives of MENA women about home-based urine cervical cancer screening using HPV kits and to assess whether such methods could positively impact future screening intent.

Methods: Through collaboration with a community partner in southeast Michigan, we recruited MENA women ages 30-65, with 44 completing the study. Participants used urine HPV self-sampling kits at home and then shared their perspectives through a phone interview. We used an inductive, thematic approach to analyze the interviews, which captured experiences with home-based self-sampling, screening preferences, and impact on future screening intent.

Results: Participants found that urine home-based self-sampling was acceptable as a convenient and comfortable way to screen for cervical cancer. Most (80%) preferred self-sampling over traditional clinician-directed screening and preferred collecting urine samples at home (73%) rather than in the clinic. Overall, 80% reported that access to urine self-sampling would positively impact their future screening intent.

Conclusions: MENA participants in this study positively received home-based cervical cancer screening using urine HPV self-sampling kits. These findings support the clinical implementation of self-sampling and home-based cervical cancer screening to increase participation, particularly among those in under-screened communities.

Keywords: Middle Eastern‐North African (MENA); cervical cancer screening; qualitative study; self‐sampling.

FIGURE 1

Barriers to cervical cancer screening: None, one, many. Central Dark Blue block: No barriers existed for 33% (13/39) of participants. Right multi‐colored block: Single barriers occurring in 41% (16/39) of participants are individually colored by the frequency of their identification. Left‐purple block: 15% (6/39) of participants had more than one barrier, which was proportionately identified according to its frequency of identification.

FIGURE 2

Mean rankings of attributes of the urine collection and pelvic exam techniques. The first three attributes are positive, and the last 11 attributes are negative. Rankings: 1 = strongly disagree, 2 = disagree, 3 = neither agree nor disagree, 4 = agree, 5 = strongly agree. All comparisons are corrected for multiple comparisons. *p < 0.05, **p < 0.01, ***p < 0.001.