Strengths and Limitations
This study should be considered in light of its limitations. First, since this was a pilot study to evaluate the interest and acceptability of using self-collection methods before rolling out the large screening program, the sample size was small. Second, it is possible that there might be information bias as the acceptability information may be influenced by the fact that the women were asked to respond to the survey by an interviewer. Despite these limitations, this was one of the first studies to examine the feasibility and acceptability of using self-collection techniques in a community based setting in a rural area of India. We used standardized tests to screen for HPV DNA and all study staff were trained to administer the surveys in a non-judgmental manner.
Based on the findings from this study, PHRII has used self-collected swabs as one of the main methods for specimen collection in all their subsequent community studies of cervical cancer screening in rural Mysore, India. This study demonstrated that self-collected swabs were preferred by a large number of women, especially when the instructions on collection were provided in a user friendly, non-judgmental manner.