Feasibility of self-sampling for HPV Dna detection in a community-based cervical cancer screening project

ABSTRACT

Objective: Paucity of resources and trained professionals makes it difficult to implement a cervical cancer screening program in India. This study aims to evaluate the feasibility of self-sampling for detection of human papillomavirus (HPV) DNA in a communitybased cervical cancer screening project. Methods: Women (30-60 years) were assigned to do self-sampling or get their samples collected by healthcare workers in outreach clinics. The samples were brought to the institute and were tested by hybrid capture2 (HC2) test for 13 high-risk HPV types. HC2 positive women were brought to the institute where they underwent colposcopy, biopsy and treatment by Thermal ablation, Cryotherapy or Loop Electrosurgical Excision Procedure (LEEP). A focussed group discussion was done with health workers involved with this project in the form of a questionnaire. Results: From May 2017 and December 2020, 15,311 women were recruited. Amongst them, 4916 (32.1%) had self-sampling and 10,395 (67.9%) had health-worker collected sample. The HC2 positivity rates in both groups were 269 (5.5%) and 652 (6.3%), which was not significantly different statistically (P = 0.06). The colposcopy rates and Cervical Intraepithelial Neoplasia (CIN) 2 and 3 detection rates were also similar. All women were comfortable with self-sampling with no sample inadequacy or wastage of collection kits. The health workers rated both procedures as acceptable. The advantage of selfsampling was that no examining table or light source was required and the screened women were less ''shy'' while sample collection. Conclusion: Self-sampling for HPV may increase participation in cervical cancer screening programs, especially in the COVID19 era.