Women treated for high grade cervical intraepithelial neoplasia (CIN) have an increased risk of recurrence of disease and cervical cancer (1, 2). Swedish cervical cancer prevention program recommend that women treated for high grade CIN should have colposcopic examination and cytology test every 2d year for 25 years. Human papillomavirus (HPV) testing with self-collected vaginal sampling (‘‘HPV self-testing’’) is one suggested strategy as test-of-cure (ToC). HPV self-testing is performed outside the healthcare provider´s office and may therefore increase accessibility to follow-up by reducing barriers such as privacy, patient costs or provider´s availability. To succeed, programs for HPV self-testing need to overcome disparities in knowledge and perceptions related to HPV, self-testing and cervical cancer prevention. In Sweden, HPV self-testing will not replace colposcopic examination, but rather may initiate the follow-up process and facilitate the early detection of recurrence of high grade CIN. Objectives:To identify possible barriers to and facilitators of HPV self-testing by (a) assessing women´s perceptions of self-testing, knowledge of HPV and perceived risk of cervical cancer (b) estimating costs incurred by women attending the clinic-based follow-up procedure (c) investigating their vaccination status and its impact on residual/recurrent HPV infection and (d) examining correlates of HPV knowledge and perceptions of self-testing.
Data on sociodemographic characteristics, cost for time and travel and other direct non-medical costs incurred in attending gynecology follow-up (e.g., indirect cost of time needed for the visit, transportation costs, child care costs, etc.), mode(s) of travel, distance, companion's attendance, knowledge of HPV and related diseases, perceptions of HPV self-test (self-collection of vaginal fluid), perceived risk of cervical cancer and vaccination status are obtained via self-administered questionnaires. For data analysis, we will use logistic and linear regression to assess bivariate associations between sociodemographic characteristics and measures related to self-testing and knowledge of HPV and cervical cancer prevention.
Data has hereby been collected from half of the 500 women included in the study population attending gynecological follow-up 6 months post first life-time treatment of high grade CIN. Results from the data analysis will be presented at the conference.
To fully grasp the potential of HPV self-testing as ToC, healthcare providers and decision makers for the cervical cancer prevention program should be aware of the levels of HPV knowledge and perceived risk related to cervical cancer.
1. Arbyn M, Sasieni P, Meijer CJ, Clavel C, Koliopoulos G, Dillner J. Chapter 9: Clinical applications of HPV testing: a summary of meta-analyses. Vaccine. 2006;24 Suppl 3:S3/78-89
2. Strander B, Andersson-Ellstrom A, Milsom I, Sparen P. Long term risk of invasive cancer after treatment for cervical intraepithelial neoplasia grade 3: population based cohort study. BMJ. 2007;335(7629):1077.