Evaluation of human papillomavirus self-collection offered by community health workers at home visits among under-screened women in Brazil

J Med Screen. 2021 Jun;28(2):163-168. doi: 10.1177/0969141320941056. Epub 2020 Jul 23.

Abstract

Objective: To explore the acceptability of high-risk human papillomavirus self-testing, involving community health workers, for never/under-screened Brazilian women. Cervical cancer is the most common cause of cancer-related death among adult women in a large number of low-income and lower-middle-income countries, where it remains a major public health problem. High-risk human papillomavirus persistence is required for the development of cervical neoplasia.

Methods: The target population was all women aged 30+ from the list of families available in healthcare centre data, who had never been screened or were not screened in the previous 3 years (under-screened women), and who were living in the 17 cities included in this study.

Results: Of the 377 women included, 16.9% (n = 64) had never had a pap smear. Of all samples included in the study, 97.1% (n = 366) were considered adequate for evaluation, as 2.9% (n = 11) were considered invalid for all high-risk human papillomavirus types. Analysing these 366 samples, 9.6% (n = 35) of the women were infected by at least one high-risk human papillomavirus type and 90.4% (n = 331) had no infection with any high-risk type of the virus.

Conclusions: Vaginal self-sampling is an adequate strategy to improve the effectiveness of the cervical cancer program by increasing screening in a high-risk group.

Keywords: Gynecological examination; mass screening; papanicolaou test; papillomaviridae; uterine cervical neoplasms.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alphapapillomavirus*
  • Brazil / epidemiology
  • Community Health Workers
  • Delivery of Health Care
  • Early Detection of Cancer
  • Female
  • House Calls
  • Humans
  • Mass Screening
  • Papanicolaou Test
  • Papillomaviridae
  • Papillomavirus Infections* / diagnosis
  • Papillomavirus Infections* / epidemiology
  • Self Care
  • Uterine Cervical Neoplasms* / diagnosis
  • Uterine Cervical Neoplasms* / epidemiology
  • Vaginal Smears