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.