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Acceptability of human papillomavirus self-collection and the role of telehealth: a prospective, randomized study stratified by menopausal status
  1. Katherine Fitch1,
  2. Jacqueline A Bohn2,
  3. Jenna B Emerson1,
  4. Emily R Boniface1 and
  5. Amanda Bruegl1
  1. 1Department of Obstetrics & Gynecology, OHSU, Portland, Oregon, USA
  2. 2Department of Obstetrics & Gynecology, University of Oklahoma, Norman, Oklahoma, USA
  1. Correspondence to Dr Katherine Fitch, Department of Obstetrics & Gynecology, OHSU, Portland, OR 97239, USA; fitchk{at}


Objective We investigated the utility of telehealth instruction versus mail-based written instruction in facilitating high-risk human papillomavirus (hrHPV) self-collection among post-menopausal patients compared with pre-menopausal patients, as well as the impact on acceptability and feasibility.

Methods We conducted a prospective, randomized study of people eligible for cervical cancer screening, stratified by menopausal status, to undergo standard written or telehealth-based instructions for hrHPV self-collection. English speaking individuals residing in Oregon, with a cervix, eligible for primary hrHPV testing, and with access to a video-capable device were included. Patients with prior hysterectomy, trachelectomy, diagnosis of cervical cancer, or pelvic radiation for gynecologic cancer were excluded. We compared preference for and opinions about self-collection and hrHPV test results, by randomization group and stratified by menopausal status using descriptive statistics.

Results Among 123 patients enrolled, 61 identified as post-menopausal with a median age of 57 years. While the majority of post-menopausal participants who received telehealth instructions found it helpful, only 6.1% considered telehealth instructions necessary to complete self-testing. There was no difference in opinion of telehealth by menopausal status. Overall, 88.5% of post-menopausal participants preferred self-collection to provider-collection. There were no significant differences between pre- and post-menopausal participants in terms of test preference, discomfort, ease of use, or perceptions of self-collection.

Conclusion Telehealth instruction did not add significant value to patients participating in hrHPV self-collection, nor did it alter the acceptability of hrHPV-self collection among an English-speaking cohort. Compared with prior experiences with provider-collected screening, hrHPV self-collection was preferred by both pre- and post-menopausal participants. There were no significant differences in preference for provider- versus self-collection when stratified by menopausal status.

  • Cervical Cancer
  • Gynecology

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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  • Contributors KF: Conceptualization, data interpretation, visualization, writing the original draft of the manuscript and implementing all revisions. JAB: Conceptualization, review and editing of the manuscript. JBE: Conceptualization, review and editing of the manuscript. ERB: Conceptualization, formal analysis and methodology, review and editing of manuscript. AB: Conceptualization, project administration, review and editing of manuscript, guarantor of project.

  • Funding Author AB is funded through an NCI K08 award and the Robert Wood Johnson Foundation. Support for this research was provided in part by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.

  • Competing interests Author AB is funded through an NCI K08 award and the Robert Wood Johnson Foundation. The remaining authors have no funding or conflicts of interest to disclose.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.