Self-sampling for cervical screening: Could it overcome some of the barriers to the Pap test?

Objectives: To determine which groups of women would be most likely to take part in self-sampling for cervical screening, and what they perceive as the key barriers and benefits to self-sampling. Methods: A random sample of 3000 women aged 18-69 in Victoria, Australia, were asked questions about "taking their own Pap test" in a telephone survey about cervical screening; 2526 answered the questions about self-sampling. The terminology "Pap test" was used in questions, due to the very low understanding of HPV and its link to cervical cancer. Results: One-third of women (34.0%) indicated they would prefer to self-sample, 57.2% would not and 8.7% were unsure. Preference for self-sampling was significantly stronger among women who had not had a Pap test for more than three years (64.8%, p < .001) or who had never had one (62.1%, p < .001), compared with those up-to-date (27.0%). Convenience was a key benefit (37.8%), as was less embarrassment (31.5%). For those who did not want to self-sample or were unsure, key factors included professionals being more skilled (53.4% and 28.2% respectively), and doubts about being able to do it properly (28.9% and 23.6%). Conclusions: Self-sampling was most popular among women who needed to have a Pap test, and could potentially reach some women who are not participating appropriately in cervical screening. Key barriers to participation could be addressed by providing information about the test being for HPV, and being easier to do properly than a Pap test.