Subscribe to RSS
Cross-Sectional Study of HPV Self-Sampling among Indian Women—A Way ForwardFunding This work was supported by the Terry Fox Foundation, Burnaby, British Columbia V5A4Y6.
Molecular human papillomavirus (HPV) DNA is a recommended test for any country planning cervical cancer screening as a national policy. The emerging literature proposes HPV self-sampling (HPV-SS) as a feasible implementing strategy in low-income settings. The success of this strategy would depend on developing impactful health education materials, understanding modalities toward generating awareness, and precision in performing the screening test among beneficiaries. The current paper is an interim analysis of ongoing research undertaken to understand the acceptability of HPV-SS among Indian women across different community settings. The study design has two modalities for generating awareness: (1) health education arm wherein the awareness and steps of collecting self-sample are explained by health personnel, and (2) the pamphlet arm wherein pictorial illustrations depicting the steps to conduct HPV-SS are distributed among women. The quality of samples is compared with primary health worker samples (PHW-S). Initial results of this study support the acceptance of HPV-SS (97%) among urban slum settings. An agreement between HPV-SS and PHW-S was demonstrated to be 95.1%. The results of the pamphlet arm were comparable to the health education arm in every aspect. The art-based strategy seems like a promising communication modality for generating awareness toward cervical cancer screening using HPV-SS in low-resource settings.
Keywordscervical cancer screening - HPV test - HPV self-sampling - art-based strategy - low-resource settings
Work to be Credited
This work is credited to the Department of Preventive Oncology, Centre for Cancer Epidemiology (CCE), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai.
Approval by all Authors
This manuscript has been read and approved by all the authors and represents honest work.
Article published online:
16 February 2022
© 2022. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
- 1 Ferlay J, Colombet M, Soerjomataram I. et al. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer 2019; 144 (08) 1941-1953
- 2 Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68 (06) 394-424
- 3 Mishra GA, Pimple SA, Shastri SS. Prevention of cervix cancer in India. Oncology 2016; 91 (Suppl. 01) 1-7
- 4 Gakidou E, Nordhagen S, Obermeyer Z. Coverage of cervical cancer screening in 57 countries: low average levels and large inequalities. PLoS Med 2008; 5 (06) e132
- 5 Arbyn M, Sankaranarayanan R, Muwonge R. et al. Pooled analysis of the accuracy of five cervical cancer screening tests assessed in eleven studies in Africa and India. Int J Cancer 2008; 123 (01) 153-160
- 6 Walboomers JM, Jacobs MV, Manos MM. et al. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol 1999; 189 (01) 12-19
- 7 Muñoz N, Bosch FX, de Sanjosé S. et al; International Agency for Research on Cancer Multicenter Cervical Cancer Study Group. Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med 2003; 348 (06) 518-527
- 8 Qiagen. HC2 HIGH-RISK TEST. United States: Qiagen Gaithersburg Inc.; 2008
- 9 Malloy C, Sherris J, Herdman C. HPV DNA Testing: Technical and Programmatic. . Seattle, Washington, Program for Appropriate Technology in Health [http://www. popline. org]. 2000 Dec.
- 10 Bruni L, Diaz M, Castellsagué X, Ferrer E, Bosch FX, de Sanjosé S. Cervical human papillomavirus prevalence in 5 continents: meta-analysis of 1 million women with normal cytological findings. J Infect Dis 2010; 202 (12) 1789-1799
- 11 IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Human papillomaviruses. IARC Monogr Eval Carcinog Risks Hum 2007; 90: 1-636
- 12 Cuzick J, Arbyn M, Sankaranarayanan R. et al. Overview of human papillomavirus-based and other novel options for cervical cancer screening in developed and developing countries. Vaccine 2008; 26 (Suppl. 10) K29-K41
- 13 World Health Organization (WHO). Comprehensive Cervical Cancer Control. A Guide to Essential Practice. Geneva: WHO; 2006
- 14 Rajaraman P, Anderson BO, Basu P. et al. Recommendations for screening and early detection of common cancers in India. Lancet Oncol 2015; 16 (07) e352-e361
- 15 Pimple S, Mishra G, Shastri S. Global strategies for cervical cancer prevention. Curr Opin Obstet Gynecol 2016; 28 (01) 4-10
- 16 Madhivanan P, Nishimura H, Ravi K. et al. Acceptability and concordance of self-versus clinician-sampling for HPVs testing among rural south Indian women. Asian Pac J Cancer Prev 2021; 22 (03) 971-976
- 17 Sowjanya AP, Jain M, Poli UR. et al. Prevalence and distribution of high-risk human papilloma virus (HPV) types in invasive squamous cell carcinoma of the cervix and in normal women in Andhra Pradesh, India. BMC Infect Dis 2005; 5: 116
- 18 Sankaranarayanan R, Swaminathan R, Brenner H. et al. Cancer survival in Africa, Asia, and Central America: a population-based study. Lancet Oncol 2010; 11 (02) 165-173
- 19 Bansil P, Wittet S, Lim JL, Winkler JL, Paul P, Jeronimo J. Acceptability of self-collection sampling for HPV-DNA testing in low-resource settings: a mixed methods approach. BMC Public Health 2014; 14: 596
- 20 Russell VL, Leeuw Sd. Intimate stories: aboriginal women's lived experiences of health services in northern British Columbia and the potential of creative arts to raise awareness about HPV, cervical cancer, and screening. J Indigenous Health 2012; 8: 18-27