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Human Papillomavirus Self-Sampling in Cameroon: Women’s Uncertainties Over the Reliability of the Method Are Barriers to Acceptance

Berner, Amandine1; Hassel, Selim Ben1; Tebeu, Pierre-Marie MD2; Untiet, Sarah MD3; Kengne-Fosso, Gisèle MD2; Navarria, Isabelle MD3; Boulvain, Michel MD3; Vassilakos, Pierre PD4; Petignat, Patrick MD3

Journal of Lower Genital Tract Disease: July 2013 - Volume 17 - Issue 3 - p 235–241
doi: 10.1097/LGT.0b013e31826b7b51
Original Articles

Objective The study aimed to assess acceptability and preference for self-collected human papillomavirus tests (self-HPV) compared with traditional physician-sampled Pap tests (physician sampling) in a low-resource country.

Materials and Methods Women were recruited through a cervical cancer screening campaign conducted in Cameroon. Written and oral instructions were given to carry out an unsupervised self-HPV, followed by a physician-collected cervical sample for HPV testing and cytology. Subsequently the women were asked to answer a questionnaire.

Results A total of 243 women were prospectively enrolled in this study. Median age of participants was 39 years (range = 25–65 years). Acceptability score was higher for self-HPV (p < .001) compared with physician sampling. Preference was lower for self-HPV than physician sampling (29% vs 62%; p < .001). Most participants thought that physician sampling was more reliable than self-HPV (59% vs 1%; p < .001). Women who preferred physician sampling were significantly more likely to have low knowledge about cervical cancer and a low educational level.

Conclusions Although most of the women were more comfortable and less embarrassed with the self-HPV, they did not trust the method and did prefer physician sampling. The study underlines the need not only to educate women about HPV, cervical cancer, and its prevention but also to reassure them about the accuracy of self-HPV.

Most participants were more comfortable with the self-HPV, but they did not trust the method and preferred physician sampling, which underlines the need for information.

1Faculty of Medicine, University of Geneva, Geneva, Switzerland; 2Department of Gynecology and Obstetrics, University Center Hospital, Yaoundé, Cameroon; 3Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland; and 4Geneva Foundation for Medical Education and Research, Geneva, Switzerland

Reprint requests to: Sarah Untiet, University Hospitals of Geneva, Department of Gynecology, Boulevard de la Cluse 30, 1211 Geneva 14, Switzerland. E-mail:

Amandine Berner and Selim Ben Hassel contributed equally.

This study was supported by a grant from “Solidarité Internationale Genève,” the University Hospitals of Geneva, and Lombard Odier Darier Hentsch & Cie.

The authors have declared they have no conflicts of interest.

Copyright © 2013 by the American Society for Colposcopy and Cervical Pathology