Women’s preferences and concerns on HPV screening sampling methods for cervical cancer in Ibadan, Nigeria: a cross-sectional study

Abstract

OBJECTIVES: This study assessed women's preferences and concerns on human papillomavirus (HPV) self-sample and healthcare provider (HCP) sample collections for cervical cancer screening in Ibadan, Nigeria. DESIGN: This was a cross-sectional study. SETTINGS: Study was conducted in primary healthcare centres in selected peri-urban and urban communities in Ibadan, Nigeria. PARTICIPANTS: A total of 620 sexually active women aged 25-65 years were recruited for the study. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the preferred method of collecting cervico-vaginal sample (self-sampling or provider sampling) by women. Secondary outcomes were observed differences in preferences between women in urban and peri-urban communities, reasons for these preferences, concerns on each method of sample collection and preferred locations for self-sample collection. RESULTS: Overall, more women preferred HCP sample collection (51.6%) than self-sampling collection (48.4%) (p=0.422). Self-sampling was more preferred among urban participants (53.7%), while HCP sample collection was more preferred among peri-urban participants (56.6%) (p=0.011). Peri-urban women preferred HCP sample collection due to clinician's expertise (90.2%) and result reliability (57.8%), while urban women preferred self-sample collection because of privacy (74.2%), comfort (62.1%) and confidentiality (55%). Most women (63.7%) preferred to self-sample in a private place in the hospital while others preferred to self-sample at home (36.3%). CONCLUSION: Preferences for HPV sample collection methods were similar, with a slightly higher proportion of women favouring HCP collection compared with self-sampling. Self-sampling was an acceptable complementary option to HCP-based sampling. Factors such as age, media access, and awareness of HPV were associated with women's preferences for sample collection methods. Integrating flexible, facility-based self-sampling within existing health services may help address contextual barriers and could potentially improve participation in cervical cancer screening programmes in Nigeria.