HPV Dectection by Self-Sampling in Nunavik, Quebec: Inuit Women's Sampling Method Preferences

There is a higher incidence of cervical cancer and prevalence of genital human papillomavirus (HPV) infection among the Inuit in Canada than the general population. Self-sampling of cervicovaginal cells for HPV testing has the potential to increase cervical cancer screening coverage in this population, but only if it is acceptable to women. We sought to determine acceptance of and preference for self-collection of cervicovaginal samples for HPV testing in comparison with provider-collection, and to explore demographic characteristics of preference for self-collection among a sample of Inuit women from Nunavik, Quebec. Women aged 18-69 years were recruited from a previously formed cohort on the natural history of HPV in Nunavik. Both self-collected and provider-collected specimens were collected with polyester-tipped swabs, and women completed a short written questionnaire immediately after specimen collection. Logistic regression was used to estimate predictors of preference. Of the 109 eligible women who were approached to participate, 93 (85%) accepted. Self-sampling was preferred by 56% of the women over provider-sampling. Education was the only predictor of preference for self-sampling, where having at least a grade 9 education was inversely associated with preference for self-sampling (OR = 0.29, 95% CI [0.09, 0.92]). Self-sampling has the potential to increase cervical cancer screening coverage, but any implementation of self-sampling should be concurrent with an education campaign on the importance of cervical cancer screening, the relationship between HPV virus and cervical cancer, and the accuracy of self-sampling.