Article Text

Download PDFPDF
Optimising human papillomavirus self-testing for high risk women
  1. Alice R Richman1,
  2. Noel T Brewer2,3,
  3. Aliza K Liebman2,
  4. Allen C Rinas4,
  5. Jennifer S Smith2,3
  1. 1Department of Health Education and Promotion, East Carolina University, College of Health and Human Performance, Greenville, North Carolina, USA (Formerly at UNC Gillings School of Global Public Health)
  2. 2University of North Carolina, Gillings School of Global Public Health, North Carolina, USA
  3. 3University of North Carolina, Lineberger Comprehensive Cancer Center, North Carolina, USA
  4. 4University of North Carolina, School of Medicine, Chapel Hill, North Carolina, USA
  1. Correspondence to Dr Alice R Richman, Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, 2209 Carol Belk Building, Greenville, NC 27858, USA; richmana{at}


Objectives Human papillomavirus self-tests that can be used at home and returned by mail may increase cervical cancer screening rates. Growing evidence suggests that self-test methods could increase screening for high-risk and hard-to-reach populations. The purpose of this study was to identify which self-test device women prefer and why.

Methods Four focus groups were conducted with 30 high-risk women in two rural and two urban counties in North Carolina. Women evaluated three self-test devices: the Pantarhei screener (a lavage that releases liquid into the vagina and re-collects fluid), the Qiagen cervical brush (a brush that women insert into the vagina and is turned around to collect cells) and the Fournier cervical self-sampling device (a tampon-like plastic wand).

Results The majority of women reported that they would use the brush (70%), followed by the wand (67%) and the lavage (43%). Women from urban areas appeared to prefer the brush, whereas women from rural areas endorsed the wand. Women reported liking the lavage because it seemed easy to use; they liked the wand because of its inviting colour (green), and liked the brush because of its small size and familiarity. Women reported disliking the lavage because the liquid seemed messy and unsanitary, disliked the wand due to the 15–20 recommended turns, and disliked the brush because it was short and the tip seemed abrasive.

Conclusions No one device was perfect, although suggestions for an optimal self-test most resembled the brush. These findings can be used to develop an optimal self-test collector for women.

  • Cancer prevention
  • cervical cancer
  • cervical cancer screening
  • HPV
  • self-collection
  • self sampling
  • self-test

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding Financial support for this study was provided by grants from the Kate B. Reynolds Foundation and the American Cancer Society (no MSRG-06-259-01-CPPB).

  • Competing interests None declared.

  • Ethics approval The institutional review board of the University of North Carolina at Chapel Hill approved the study protocol and materials.

  • Provenance and peer review Not commissioned; externally peer reviewed.