Preferences among women for home-based self-sampling over clinic-based provider-collection for cervical cancer screening in the US.

Abstract

e22572 Background: Self-sampling for human papillomavirus testing is an evidence-based strategy that can improve cervical cancer screening access and increase screening uptake among under-screened populations. However, preference for and drivers of home-based self-sampling over clinic-based testing (the current standard of care) have not yet been fully studied among screening-eligible women in the US. Methods: Using the 2024 US Health Interview National Trends Survey (HINTS 7) data, we conducted a cross-sectional analysis of women eligible for cervical cancer screening to assess their perspectives about at-home self-sampling for cervical cancer screening and factors associated with preferring this sampling method. We also examined reasons for considering home-based self-sampling for cervical cancer screening. Results: Among the 2,300 women (mean age: 45.5 years, SD: 29.2) included in this study, most were non-Hispanic Whites (60.3%), married/living as married (58.2%), insured (91.9%), and educated up to post-high school or some college (61.6%). Of these, 20.4% preferred at-home self-sampling, 60.8% preferred clinic-based testing, and 18.8% were uncertain about their choice. Non-Hispanic Black women (aOR: 0.45 [95% CI: 0.21–0.96]) had lower odds of preferring at-home self-sampling over clinic-based testing compared to Non-Hispanic Whites. Women who had experienced prejudice or discrimination when getting medical care had higher odds (1.94 [1.16–3.22]) of preferring at-home self-sampling. The most commonly reported reasons for preferring at-home self-sampling were: privacy (54.9%), time constraints (35.1%), and avoiding embarrassment (33.4%). Conclusions: A small proportion of cervical cancer screening-eligible women in the US prefer at-home self-sampling over clinic-based testing. To address cervical cancer inequities and increase screening uptake among under-screened populations, US guidelines should incorporate this innovative screening strategy, and targeted interventions to promote home-based self-sampling are needed.