Feasibility and Acceptability of Human Papillomavirus Based Self-sampling in Underserved Minorities in the United States: A Scoping Review

Abstract

Objective: The aim of the review evaluates the feasibility and acceptability of human papillomavirus (HPV) self-sampling in underscreened communities to increase cervical cancer screening rates in the United States.

Methods: Database searches were conducted on PubMed, CINAHL, MEDLINE, CENTRAL, and ClinicalTrials.gov using the following search terms: HPV or human papillomavirus viruses, self-sampling, self-swabbing, or self-collection, acceptability, feasibility, and United States. The study aims to identify factors related to the feasibility and acceptability of HPV self-sampling uptake.

Results: Sixteen studies were included in this scoping review. Most studies reviewed associated factors, such as demographic data (age and ethnicity), and socioeconomic data (income, education level, and insurance status). There was a higher HPV self-sampling rate (75%-100%) in the 11 studies where there was an in-person component including completing self-sampling kits in-person after recruitment, scheduled appointments or education sessions compared with studies where kits were returned by mail (3%-93%). Eleven studies measured acceptability and/or feasibility, and subjects reported the self-sampling process and devices were acceptable and easy to use. Of the 11 that measured feasibility and acceptability, 3 studies noted that the majority preferred self-sampling over clinician-collected Pap tests. Six studies incorporated community health worker-led education prior to distributing self-sampling kits, and improved attitudes toward self-sampling. Two studies evaluated the incidence of abnormal results between self-sampling and clinician-collected Pap test and found no difference.

Conclusions: HPV self-sampling is seen as an acceptable and feasible option for cervical cancer screening for underscreened individuals. Furthermore, patient-facing education components led by community health workers greatly influenced participants' decision to self-sample.

Keywords: HPV; HPV self-sampling; cervical cancer; cervical cancer screening; community health workers; minorities; self-sampling kits; underserved population.