Turkish and Moroccan Dutch women's views of using a self-sampling kit for human papillomavirus testing as a tool for cervical cancer screening: What are the barriers and the motivators?

Objective: This study explores barriers and motivators to use self-sampling kits for human papillomavirus testing for cervical cancer screening as perceived by Dutch women of Turkish and Moroccan origin living in the Netherlands. Methods: A total of II in-depth semi-structured interviews were conducted and structured according to the theory of planned behavior. Results: Findings suggest that self-sampling may lift important barriers hampering traditional cervical cancer screening, such as those related to shame and chastity. However, self-sampling raises its own barriers too. Most importantly, some women fear that self-sampling may harm virginity. Some women also do not feel confident about their ability to properly use the self-sampling kit, but fears about the inability to properly use it often fade away upon having seen the self-sampling kit. Moreover, results show that knowledge about cervical cancer and its origin is limited, which may undermine women's willingness to participate in a screening program. Conclusions: These results suggest that communication strategies to encourage using self-sampling kits among women of Turkish and Moroccan origin could benefit from culturally sensitive approaches, for example, by placing emphasis on issues such as virginity and chastity. Consistent with a recent advice of the Health Council of the Netherlands, the kit could furthermore be sent to eligible women as a standard procedure, rather than upon request. This could reduce hassle and doubts about women's ability to use the self-sampling kit. Finally, educating women about the importance of screening to prevent cervical cancer is needed to foster informed decision-making.