Acceptability and preference of self-collected vaginal samples for human papillomavirus DNA testing compared with physician-collected Pap smear

Abstract

BACKGROUND: Self-collected vaginal sampling for human papillomavirus (HPV) DNA testing provides a promising alternative to physician-collected Pap smears, especially in low-resource settings. However, data on its acceptability and preferences among Filipino women remain limited. This study aimed to assess women's perceptions, experiences, willingness and preferences regarding self-collected vaginal sampling for HPV DNA testing compared with Pap smears. METHODS: A cross-sectional study was conducted among 592 women. Participants underwent both physician-collected Pap smears and self-collected vaginal sampling for HPV DNA testing. Perceptions were measured using five-point Likert scale questionnaires before and after self-collection. Descriptive statistics were used, and paired and independent Wilcoxon tests were used to compare Likert responses. Willingness to undergo screening was analyzed with Cochran's Q and McNemar tests. Participants' reasons for their preferred screening method were categorized thematically and displayed in stacked bar charts. RESULTS: Self-collection was generally viewed as painless, not uncomfortable, non-embarrassing, and easy and convenient. Acceptability significantly increased after participants performed self-collection (P < 0.001 for pain and discomfort). Compared with Pap smears, self-collection was seen as less embarrassing (P < 0.001), but rated as less easy (P = 0.01) and less convenient (P = 0.004). Most participants preferred physician-administered screening (84.8%) due to trust in medical expertise, and confidence in the procedure's accuracy, safety and cleanliness. CONCLUSIONS: Self-collected vaginal sampling was highly acceptable, yet physician-collected screening remained the preferred method. Improving education, demonstrations, and support for self-collection may enhance the uptake of HPV DNA testing and broaden access to cervical cancer screening in the Philippines.