By Dr Philippa White, Specialist Registrar in Public Health Medicine, National Screening Service
We’ve carried out new research in 2023 to understand attitudes and preferences towards HPV self-sampling for cervical screening among registered CervicalCheck GPs and practice nurses (sample takers). 200 sample takers took part in the online survey. The findings show that two out of three sample takers think that self-sampling for HPV should be introduced as an additional method for cervical screening in Ireland.
Acceptance of HPV self-sampling
The majority (67%) of survey respondents thought that HPV self-sampling should be introduced as a method of cervical screening in Ireland. The main reason given by sample takers is because they thought that this method could increase uptake of cervical screening. Other reasons included giving screening participants a choice of a test without a speculum, convenience for screening participants, and less embarrassment and anxiety for participants.
A small percentage (9%) thought that HPV self-sampling should not be introduced. The main reasons given were lack of opportunities to discuss other health concerns with patients or counsel them about screening; and concerns that a self-sampled test may contain error or miss an abnormal result. The remaining 24% of respondents were not sure if HPV self-sampling should be introduced.
Delivering HPV self-sampling
The majority of sample takers (7 out of 10) thought HPV self-sampling should take place at home, while 1 out of 10 thought it should take place in a GP practice. Those who thought HPV self-sampling should take place in the participants’ homes believed this would be more convenient for screening participants, that it would give them more privacy and that screening participants would probably prefer this.
However, survey respondents had different views on how much GPs, practice nurses and other local health services should be involved in the delivery of HPV self-sampling.
- Half of the survey respondents thought a screening participant’s local GP practice should be involved in the delivery of HPV self-sampling, whether through providing instructions on how to take a self-sampled test, counselling participants about screening, explaining screening results or organising follow-up for screening participants.
- Half of respondents thought CervicalCheck should organise the delivery of HPV self-sampling, without involving the screening participant’s local GP practice.
Advantages and disadvantages of HPV self-sampling
Survey respondents thought the main advantages of introducing HPV self-sampling for them would be more time to spend with other patients and less administrative work. The main disadvantages cited were fewer opportunities to examine patients and counsel them about screening.
Conclusion
There is support among registered CervicalCheck GPs and practice nurses for the introduction of HPV self-sampling as an additional method for cervical screening in Ireland. The majority would like self-sampling for HPV to take place at home, but they are divided on how much involvement they should have in the delivery of HPV self-sampling.
Cervical Cancer Elimination: Exploring the potential of self-sampling for cervical screening is part of Ireland’s roadmap towards Cervical Cancer Elimination. In 2024, the Cervical Cancer Elimination Partnership will launch a public consultation to develop a national action plan and ensure Ireland remains on track to eliminate cervical cancer by 2040. If you would like to be involved in this consultation, email PublicHealth.Support@screeningservice.ie
Thank you to all the sample takers who participated in this research.