Experiences with HPV self-sampling in India: advancing cervical cancer prevention and screening.

INTRODUCTION

Cervical cancer is the second common cancer among Indian women, with incidence of 17.7 per 100,000 women and a national screening coverage of less than 2%. HPV-Self Sampling (SS) offers a promising opportunity to expand screening coverage. However, understanding the feasibility of this method within the local context is crucial before implementing it as a large-scale intervention.

OBJECTIVE

To assess the feasibility of HPV self-sampling (HPV-SS) by exploring the determinants of participation, user experiences and care trajectory among screen positive women on HPV-SS from urban non slum, urban slum, rural and tribal settings in India. METHODOLOGY: Eligible women in age group of 30–69 years were invited to participate in the study. Women enrolled in the study were delivered in-depth education on cervical cancer. In post education session, women were invited to participate in cervical cancer screening, using HPV-SS.

RESULTS

The initial participation rate in the study was 66%. The acceptance of HPV-SS was 98.2% after health education among enrolled women. The prevalence of oncogenic HPV ranged from 4.4% to 11.2%, with the highest rates observed in tribal population. Compliance with referral among screen-positive women was 82% in urban non-slum areas and 89% from urban slum settings. In rural and tribal settings, compliance rates were 67% and 89%, respectively, following the organization of community camp. Perception of self-confidence in the accuracy of collecting self-samples and preference for HPV-SS over provider-collected samples varied across the settings.

CONCLUSION

The study highlights HPV-SS as a key driver for scaling up cervical cancer screening coverage. However, initial low participation rates for cervical cancer screening, underscores the need for continuous community awareness efforts and capacity-building among grass root healthcare personnel. Though HPV-SS appears promising, challenges such as limited access to designated laboratories and accessibility to treatment facilities remain significant barriers of widespread implementation.