Main Findings
This study was designed to inform the feasibility and acceptability for
conducting community based cervical cancer screening programs using
mobile clinics in rural communities in India. The study has reiterated
that self-collection of vaginal samples was feasible and acceptable to
women living in rural India. In fact, they preferred self-collection and
were comfortable with the process. By using self-collected samples to
rule out HPV infection, it is possible to reduce missed opportunities
for screening in rural India.
Additional considerations for the feasibility of large-scale HPV
self-sampling campaigns concern accuracy of results of the self-sampling
process. This study found comparable performance and accuracy of
self-collection for detection of high-risk HPV DNA. There have been
several studies comparing HPV screening results from self-collected and
clinician-collected specimens in low- and middle-income countries with
all demonstrating high levels of agreement.16-22 A
review and meta-analysis of 21 studies did not detect statistical
significance difference in sensitivity of self-collected specimens
compared to clinician-collected specimens. The authors suggested a
pooled analysis of sensitivity data to detect whether sampling methods
yielded statistically different sensitivities. The majority of studies
in the review reported similar specificity for both sampling
methods.23 Clinically, the data suggested that
self-sampling of HPV specimens was a viable alternative to
clinician-sampling.