HPV Detection by Self-Sampling in Nunavik, Quebec: Inuit Women’s Sampling Method Preferences
By Helen Cerigo MSc1, Mary Ellen Macdonald PhD4, Eduardo L. Franco PhD1, 2 and Paul Brassard MD MSc1, 3
Screening for cervical cancer is most often done with a Papanicolaou (Pap) smear, where a health care provider uses a swab to collect cells from the cervix. In areas where few women take part in cervical cancer screening programs, self-sampling of cervicovaginal cells has been suggested as a way to increase participation in screening. The authors of this study wanted to find out whether Inuit women in Nunavik, Quebec—an area with high rates of HPV infection and cervical cancer—preferred provider-sampling or self-sampling. A total of 93 women participated in the study, both collecting their own samples and undergoing a standard Pap smear test with a nurse practitioner. Participants completed questionnaires about which method they preferred and why. The authors also looked at socio-demographic and lifestyle variables such as education level and medical history to see if there was any association with sampling method preference. Self-sampling was preferred by 56% of women in the study, and was associated with having less than a grade 9 education. Women who had completed at least grade 9 tended to prefer provider-sampling. Among women who preferred to collect their own sample, reasons for their preference included increased comfort and privacy. Women who preferred sampling by a health care provider expressed concerns that they might not be able to correctly collect their own sample and many found provider-sampling easier and more convenient. Women in this study were recruited from a cohort that was already involved in regular cervical cancer screening, so the results may not be applicable to unscreened women in Nunavik. The results do suggest, however, that self-sampling may have the potential to increase participation in cervical cancer screening programs, especially among women who are uncomfortable with Pap smear testing.
1 Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University
2 Division of Oncology, Faculty of Medicine, McGill University
3 Department of Medicine, Faculty of Medicine, McGill University
4 Division of Oral Health and Society, Faculty of Dentistry, McGill University