Acceptance of human papillomavirus self-sampling in underserved and under-screened communities in Canada: a literature review

Abstract

Cervical cancer is the fourth most common cancer among women. In Canada, the disease accounted for roughly 400 deaths from 1,550 diagnoses in 2017 alone. Nearly all cases of cervical cancer are due to persistent infection with human papillomavirus (HPV). Most cervical cancer cases can be prevented with screening, and those who develop cervical cancer tend to be classified as under-screened or never-screened. Often, these people belong to underserved groups such as immigrants, racialized individuals, and those living in rural communities. Traditional cervical cancer screening involves Pap (Papanicolaou) tests while self-sampling allows people with a cervix to collect their own sample, when and where they choose. This literature review examined Canadian studies exploring the acceptance of self-sampling amongst underserved populations. The findings of this review support the idea that most underserved and underscreened populations accept and support the idea of HPV self-sampling. Common reasons for acceptance of self-sampling included convenience, privacy, and timesaving. The most commonly reported concern was a lack of confidence in performing the test correctly. While the studies included in this review do not represent every underserved population in Canada, the results suggest that with proper education and support, HPV self-sampling could be a useful addition to cervical cancer screening in Canada.