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A cross-sectional study on the acceptability of self-collection for HPV testing among women in rural China
  1. YaoYao Guan1,
  2. Philip E Castle2,
  3. Shaoming Wang3,
  4. Belinda Li3,
  5. Changyan Feng3,
  6. Puwa Ci3,
  7. Xue Li3,
  8. Patti Gravitt4,5,
  9. You-Lin Qiao3
  1. 1Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  2. 2American Society for Clinical Pathology Institute, Washington, DC, USA
  3. 3Department of Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
  4. 4Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
  5. 5Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
  1. Correspondence to YaoYao Guan, School of Medicine, Johns Hopkins University, 733 N. Broadway, Suite 137, Baltimore, MD 21205-2196, USA; yguan5{at}


Objective To assess the acceptability of using self-collection as a method of sampling for human papilloma virus testing in rural China.

Methods 174 women from the national cervical cancer screening programme in Xiangyuan County, China, were enrolled in our study and underwent self-collection, clinician collection, colposcopy examination and were administered questionnaire. The questionnaire assessed the patients' preference and acceptability of collection method.

Results The mean overall acceptability score for self-collection, although significantly less than the overall score for clinician collection (p<0.01), still is well above 4 (4.33 of 5), indicating high acceptability. The acceptability scores for self-collection and clinician collection were not significantly different on scales measuring comfort and convenience (p>0.05). The scores were significantly lower for self-collection on scales measuring trust, ability to collect specimen and perceived effects of testing compared with clinician collection (p<0.01). 74% of participants preferred clinician collection, and of these participants, 86% preferred it because they thought the results were more accurate.

Conclusions The study shows that self-collection was highly acceptable and that self-collection and clinician collection were equally comfortable and convenient; however, the participants still preferred clinician collection because of lack of trust in the results of self-collection. This indicates that self-collection is an acceptable potential method for screening but education programmes about the validity of self-collection that target general population may be needed prior to implementation.

  • HPV
  • China
  • women
  • cervical neoplasia
  • patients-views
  • children
  • cervicitis
  • testing
  • cervical cancer
  • self-sampling
  • cervix
  • epidemiology

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  • Funding This study was supported by the Cancer Institute/Hospital, Chinese Academy of Medical Sciences Department of Epidemiology, the Johns Hopkins University Departments of Epidemiology and Molecular Microbiology and Immunology, and the Chinese National Cancer Screening Project for Cervical Cancer and Breast Cancer Among Rural Women. The FTA cards used in this study were donated by GE healthcare. PEC was previously supported by the Intramural Research Program of the NIH/NCI.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by the Ethics Committee of Cancer Institute and Hospital, Chinese Academy of Medical Sciences.

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