Acceptability of Human Papillomavirus Self-Sampling for Cervical Cancer Screening in an Indigenous Community in Guatemala
Open accessAbstract
Purpose: Cervical cancer rates in Latin America are higher than those in developed countries, likely because of the lower prevalence of screening. Specifically, less than 40% of women in Guatemala are regularly screened and even fewer women are screened in indigenous communities. Current screening strategies—Pap smears and visual inspection with acetic acid—might not be the most effective methods for controlling cancer in these settings. We thus investigated the potential of self-collection of cervical samples with testing for human papillomavirus (HPV) to help prevent cervical cancer in an indigenous community in Guatemala. Patients and Methods: A community representative random sample of 202 indigenous women age 18 to 60 years residing in Santiago Atitlan, Guatemala, were surveyed to assess knowledge of and risk factors for HPV and cervical cancer. Women were then invited to self-collect a cervical sample using HerSwab collection kits to assess the prevalence of HPV and the acceptability of self-sampling. Results: Of 202 women who completed the survey, 178 (89%) provided a self-sample. In all, 79% of these women found the test comfortable, 91% found the test easy to use, and 100% reported they were willing to perform the test periodically as a screening method. Thirty-one samples (17%) were positive for at least one of 13 high-risk HPV types, and eight (4.5%) were positive for HPV 16/18. Conclusion: HPV testing by using self-collected samples was well accepted, suggesting that it is a plausible modality for cervical cancer screening in indigenous communities. Further studies are needed to assess rates of follow-up after a positive test and to determine whether these findings extend to other indigenous and nonindigenous communities in Guatemala and Latin America.
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The finding that women in rural western Kenya had positive expectations of and personal experiences with HPV self-sampling is consistent with other studies done in Africa and Asia.
“which is consistent to other studies done in Africa and Asia [18, 19, 33–35].”
From Perspectives of women participating in a cervical cancer screening campaign with community-based HPV self-sampling in rural western Kenya: a qualitative study (2019) · cites this paper as [33]
The Discussion reports high acceptability and positive experiences with HPV self-collection, and says its results are consistent with previous studies in Asia and Africa. But this source’s own study was conducted in Guatemala, not Africa or Asia; it also does not assess women in rural western Kenya. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe finding on pelvic exam as a barrier to screening is consistent with other studies done in Africa and Asia which showed concerns around speculum use, embarrassment, and reluctance to have a male provider perform the exam.
“The findings on pelvic exam as a barrier to screening is consistent with other studies done in Africa and Asia [18, 19, 33–35] which showed concerns around speculum use, embarrassment, and reluctance to have a male provider perform the exam [37–39].”
From Perspectives of women participating in a cervical cancer screening campaign with community-based HPV self-sampling in rural western Kenya: a qualitative study (2019) · cites this paper as [33]
The Results (Self-Collection Acceptability; page unavailable) report that most participants preferred screening at home to screening by a physician. Our copy does not say why: searches for speculum use, embarrassment, and reluctance to see a male provider found no passage addressing those concerns. The Discussion’s comparison with studies in Africa and Asia concerns acceptance of self-screening, not those specific barriers. (LLM, conf=0.72)
Experimental — accuracy not yet measured
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- Authors
- Gottschlich, A., Rivera-Andrade, A., Grajeda, E., Alvarez, C., Mendoza Montano, C., & Meza, R.
- Affiliations
- Hebrew University of Jerusalem (IL)
- Anna Gottschlich, Christian Alvarez, and Rafael Meza, University of Michigan, Ann Arbor, MI; Alvaro Rivera-Andrade and Carlos Mendoza Montano, Institute of Nutrition of Central America and Panama; Carlos Mendoza Montano, Universidad Mariano Galvez de Guatemala; Edwin Grajeda, Universidad Rafael Landivar, Guatemala City, Guatemala; and Alvaro Rivera-Andrade, The Hebrew University, Jerusalem, Israel.
- Corresponding author
- Meza, Rafael
- Venue
- Journal of Global Oncology
- Published
- 2017-10
- Volume
- 3
- Issue
- 5
- Pages
- 444-454
- ISSN
- 2378-9506 (ISSN-L)
- PMC
- PMC5646882
- OpenAlex
- W2582185508
- Cited by
- 72
- References
- 37
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 11 · 2023: 11 · 2022: 12 · 2021: 5 · 2020: 7 · 2019: 10 · 2018: 7
- FWCI
- 5.14
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Global Oncology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Cancer Institute (U01CA182915, T32CA083654)
- 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
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Keywords
- human papillomavirus, HPV self-sampling, cervical cancer screening, indigenous women, acceptability, high-risk HPV prevalence, HPV 16/18, cervical cancer prevention, Santiago Atitlán, Guatemala
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