A Pilot Study Investigating Acceptability of HPV Self-Sampling in Japanese Women of Reproductive Age

INTRODUCTION: Cervical cancer (CC) is increasing in Japanese women of reproductive age. Most CCs occur in women who do not undergo regular cervical screening. This represents around 70% of young Japanese women. Thus, strategies to increase screening uptake are necessary. Studies have shown that human papillomavirus self-sampling (HPV self-sampling) is an inexpensive and well-accepted method for HPV detection that can increase non-responder participation in CC screening programs. However, no such study has taken place in Japan. The aim of this pilot-study was therefore to assess acceptability and preference for HPV self-sampling compared with traditional physician-sampled Pap tests (physician sampling) in a Japanese population.

METHODS:  After obtaining informed consent, 150 women aged 20-49yrs undergoing CC screening between September and November 2013 at a screening center in Sapporo were included in the study. Participants performed HPV self-sampling unsupervised, using a written instruction sheet and then a physician did a routine Pap smear and HPV test. Immediately after both tests, participants completed a measure of acceptability for each test, and answered questions about socio-economic status, comprehension of the instruction sheet and willingness to use self-sampling in the future.

RESULTS: Self-sampling was more acceptable than physician sampling (65.8% vs 32.2%), with no statistically significant difference according to age, educational background, parity, marital status or history of tampon use. Willingness to use self-sampling in the future was also high (86.8%). However 29.3% of participants expressed a lack of confidence that the test had been performed correctly.

 CONCLUSIONS:  Acceptance of self-sampling was high and participants could perform the test unsupervised, using simple written instructions. However, the sample size was small and, consistent with previous studies, women expressed concerns about performing the test properly. Further large-scale studies are needed, particularly in non-responders, and educational interventions to reassure women about the accuracy of HPV self-sampling are necessary.