Acceptability of self-sampling and human papillomavirus testing among non-attenders of cervical cancer screening programs in El Salvador
Open accessAbstract
In a cross-sectional study carried out in El Salvador between February 2016 and July 2017, self-sampling and human papillomavirus (HPV) testing was found to be highly acceptable among 2019 women who had not attended a cervical cancer screening in at least 3 years. Within this population, HPV positivity rates differed according to age, marital status, number of children, and lifetime sexual partners. The proportion of women who tested HPV positive or who were diagnosed with cervical intraepithelial neoplasia grade 2 (CIN2) or more severe diagnoses (CIN2+) was similar to the general population of the area. Among the reasons for failing to participate in previous screening programs, non-attending women described logistic concerns, but also erroneous beliefs regarding HPV and cervical cancer, misconceptions regarding the screening procedure, discomfort with male providers, and confidentiality fears. The aim of this study was to identify opportunities and challenges that emerged from the use of self-sampling and HPV testing as part of a public cervical cancer control effort in a low-resource setting.
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Pain and discomfort have been barriers to CC home-testing.
“Pain and discomfort have been barriers to CC home-testing [22,26].”
From Improving cancer screening uptake: A behavioural and cultural insights perspective and rapid review (2026) · cites this paper as [22]
The Results report that 27.1% of participants believed screening would be painful, but this was a reason for missing previous clinic-based screening appointments, not a reported barrier to home-testing. The Results instead describe home self-sampling as comfortable and highly acceptable. (LLM, conf=0.86)
Experimental — accuracy not yet measuredCompeting life demands such as other diseases, childcare responsibility, no possibility to take time off, and being busy with housework are widely cited barriers.
“Barriers such as other diseases, responsibility of childcare, no possibility to take time off, and being busy with housework are widely cited [9,13,22,23,30].”
From Improving cancer screening uptake: A behavioural and cultural insights perspective and rapid review (2026) · cites this paper as [22]
The Results report long clinic wait times as a commonly cited reason for missing screening, and the Discussion also mentions inconvenient appointment times. Those passages support a general point about logistical barriers, but our copy does not document other diseases, childcare, inability to take time off, or housework as widely cited barriers. (LLM, conf=0.76)
Experimental — accuracy not yet measuredLong wait times can be a barrier.
“Long wait times can be a barrier [22,26], whereas more flexible access, e.g., flexible scheduling or options for screening facilities can increase attendance [10].”
From Improving cancer screening uptake: A behavioural and cultural insights perspective and rapid review (2026) · cites this paper as [22]
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Cites
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Research works printed but not linked: 22
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Sorted by citations
HPV self-sampling for cervical cancer screening: a systematic review of values and preferences
Nishimura, H., Yeh, P. T., Oguntade, H., Kennedy, C. E., & Narasimhan, M. (2021) · BMJ Global Health · doi:10.1136/bmjgh-2020-003743 · Cited by 222 · see citing works
Vallone, F., Lemmo, D., Martino, M. L., Donizzetti, A. R., Freda, M. F., Palumbo, F., Lorenzo, E., D’Argenzio, A., & Caso, D. (2022) · Psycho-Oncology · doi:10.1002/pon.5997 · Cited by 65 · see citing works
Improving cancer screening uptake: A behavioural and cultural insights perspective and rapid review
Palsola, M., Likki, T., Snijders, V., Corbex, M., Lasierra, L., & Curtis, B. (2026) · Glasnik javnog zdravlja · doi:10.5937/serbjph2601086p
- Authors
- Maza, M., Melendez, M., Masch, R., Alfaro, K., Chacon, A., Gonzalez, E., Soler, M., Conzuelo-Rodriguez, G., Gage, J. C., Alonzo, T. A., Castle, P. E., Felix, J. C., & Cremer, M.
- Affiliations
- Ministerio de Salud (SV)
- National Institutes of Health (US)
- University of Southern California (US)
- Albert Einstein College of Medicine (US)
- Medical College of Wisconsin (US)
- Cleveland Clinic (US)
- Corresponding author
- Soler, M.
- Venue
- Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 2018-09
- Volume
- 114
- Pages
- 149-155
- ISSN
- 0091-7435 (ISSN-L)
- OpenAlex
- W2810451746
- Cited by
- 37
- References
- 1
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 4 · 2022: 11 · 2021: 5 · 2020: 8 · 2019: 2
- FWCI
- 2.94
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Preventive Medicine (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Rising Tide Foundation (CCR-15-400)
- Topics
- Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- self-sampling, HPV testing, cervical cancer screening, acceptability, cervical intraepithelial neoplasia, HPV prevalence, barriers to screening, confidentiality, resource-limited settings, El Salvador
- MeSH terms
- Adult, Uterine Cervical Dysplasia, Uterine Cervical Neoplasms, Cross-Sectional Studies, El Salvador, Female, Humans, Mass Screening, Middle Aged, Rural Population, Specimen Handling, Vaginal Smears, Papillomaviridae, Papillomavirus Infections, Early Detection of Cancer
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