Experience with Cervical Cancer Screening and Views on HPV Self-Sampling Among Somali American Women.

BACKGROUND

Somali American women have lower cervical cancer screening rates than the general US population. Human papillomavirus (HPV) testing on self-collected samples (HPV self-sampling) has the potential to address cervical cancer screening disparities affecting Somali American women. This study aimed to understand Somali American women's perspectives on cervical cancer screening and HPV self-sampling.

METHODS

Forty-four Somali American women participated in six focus groups. Participants were between 30 and 65 years old and were eligible for cervical cancer screening. The discussions focused on women's experiences with cervical cancer screening, barriers to screening, views on HPV self-sampling, and recommendations to increase screening participation.

FINDINGS: While some participants' prior experiences with cervical cancer screening were positive, many reported coercive, distressing, and frightening experiences with screening. A range of barriers was reported, and these included fear, distrust, low awareness of cervical cancer, modesty concerns, being circumcised, and limited access, including not being offered screening. Participants viewed HPV self-sampling favorably, with minor concerns about test validity or ability to collect samples correctly. Overall, participants felt HPV self-sampling should be routinely offered to all Somali American patients.

CONCLUSION

Offering HPV self-sampling to Somali American women could be an important tool to address barriers related to modesty and access to care and may be most effective implemented alongside education to raise awareness about cervical cancer. This modality may be particularly important for patients who have had traumatic or coercive screening experiences and for patients who have experienced female genital circumcision.

CLINICAL TRIAL REGISTRATION: NCT05453006.