Preferences and motivations for self-collection HPV testing among cervical cancer screening-eligible U.S. women: A nationally representative study.

Abstract

e17528 Background: The United States Food and Drug Administration recently approved the human papillomavirus (HPV) self-collection test as a screening option for cervical cancer, a pivotal step toward improving cervical cancer screening rates through patient-centered innovation. However, little is known about population-level preferences for this self-collection screening method, as well as the factors that drive preference for home testing among screening-eligible women. Methods: Study data was derived from the Health Information National Trends Survey (HINTS 7, 2024). The study population included cervical cancer screening-eligible women aged 21 to 65 years, with no prior cervical cancer diagnosis. Prevalence estimates were used to describe preferences for at-home versus clinic-based cervical cancer testing, as well as self-reported reasons for preferring home-based collection. Multiple bivariate logistic regression models were used to investigate associations between respondents’ sociodemographic characteristics and preference for self-collection screening. Results: A total of 2,272 women were included in the analysis, with a mean age of 45.2 years. For race and ethnicity, 48.6% represented Non-Hispanic White, 24.2% Hispanic, 16.3% Non-Hispanic Black, 5.1% Non-Hispanic Asian, and 4.0% Other Non-Hispanics. Overall, 20.2% preferred at-home testing, 60.7% preferred testing in a doctor’s office, and 19.1% were unsure about their preference. The most frequently cited reasons for preferring at-home testing included privacy (65.4%), avoiding time off work (39.7%), avoiding embarrassment (32.9%), saving transport costs (32.2%), and distance to provider (11.6%). Compared with Non-Hispanic White women, Non-Hispanic Black, Hispanic, and Non-Hispanic Asian women had significantly lower odds of preferring home-based testing (OR = 0.39, p < 0.001; OR = 0.63, p = 0.001; and OR = 0.53, p = 0.024), respectively. No significant associations were observed between preference for home testing and age, marital status, weekly working hours, household income, body mass index, or prior cancer diagnosis history. Conclusions: Roughly one in five screening-eligible U.S. women expressed preference for at-home cervical cancer testing, primarily motivated by privacy, interruptions with work, saving cost, and convenience. Preference for self-testing is lower with other races compared to non-Hispanic Whites. Integrating self-collection into national screening programs could be a promising strategy in not only improving screening rates but also reducing structural barriers, improving participation among underserved women, and accelerating progress toward cervical cancer elimination in the United States.