Introduction/Background Evidence suggest HPV based primary cervical cancer screening to be most promising. HPV-self sampling (HPV-SS) has been investigated for improving cervical cancer screening coverage in high income countries. Success of HPV-Self sampling (HPV-SS) in resource constrained countries like India, with diverse population, will depend on developing impactful beneficiary-centered health education material, social and behavioral approaches to inform and educate women towards cervical cancer and HPV-SS and on precision in performing test by beneficiaries. The current study was undertaken with objectives to determine knowledge, attitudes and practices (KAP), acceptability, barriers, agreement rates and prevalence of HPV in different population subgroups using varied methods of communication.
Methodology The current study enrolled 1600 women in age group of 30–55 yrs, from urban slums (500), urban non-slums (500) and rural (600) settings in Maharashtra, India. Information regarding cervical cancer and steps for collecting self-sample was explained by two modalities; health education by trained health personnel in health education arm and through printed pictorial depiction in the pamphlet arm. One sample for HPV testing was collected by health personnel for each participant in both arms.
Results Overall prevalence of HPV was 7.8% with no significant differences across the settings. Overall acceptance of HPV-SS was 98.4%. Awareness regarding cervical cancer and HPV-SS was similar across settings and modalities of education. The overall concordance rates between HPV-SS and health personnel collected sample was 94.8% (k=0.508, CI=0.458–0.559, p<0.001) and was similar across settings. Compliance for clinical assessment of screen positive women and for treatment was 76.8% and 80% respectively.
Conclusion The study demonstrated that HPV-SS is acceptable, feasible and implementable in India and will assist in improving cervical cancer screening coverage.
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