Search

Simple Summary: In spite of effective preventive tools, an estimated 3159 women were still diagnosed with cervical cancer (CC) in France in 2023, and 1117 died from the disease. We investigated women's opinions on CC screening and how the offer of self-sampling kits could address barriers impeding the outreach of under-screened populations in three rural French administrative departments with low medical density and/or low screening participation rates. The qualitative study confirmed acceptability to receive self-sampling kits but also highlighted the need for clear, adapted, and simple instructions and information (preferably from a healthcare professional) on what to do in case of a positive result. Women embarrassed by genital self-examination may prefer urine collection kits. Cervical cancer (CC) was diagnosed in 3159 women in France in 2023, and 1117 died from it. Organized screening for cervical cancer is potentially very effective for participating women. However, reaching under-screened populations remains a major challenge. The present qualitative study explored women's opinions on what discourages or encourages them to participate in CC screening and assessed the acceptability of two experimental strategies (urinary or vaginal self-sampling kits) to increase the screening coverage in three rural French administrative departments with low medical density and/or low screening participation rates. Forty-eight semi-structured interviews and four focus groups were conducted by a team of psychologists. Results showed that the participants accepted at-home self-sampling to reach non-participating women in medically underserved areas. However, they suggested that the type of kit sent should be adapted to the patient's profile (embarrassment from earlier exams, cultural aspects, fear of invasiveness, etc.), and that kits should be simple to use (in understandable language taking sociocultural aspects into account). Women wished to be assured that testing on self-samples is accurate and needed information about further actions in case of a positive result. [ABSTRACT FROM AUTHOR]

Simple Summary: Cervical cancer is an important and preventable disease. Logistical, financial, organizational, and psychological barriers must be addressed to reach adult women not attending screening. The present qualitative study examined these barriers for women and explored effective screening strategies in areas of France with fewer doctors and suboptimal access to health facilities. Healthcare professionals were interviewed on the advantages and disadvantages of mailing vaginal or urine self-sampling kits. Self-sampling has been shown to be an effective tool for reaching underscreened women. Our survey highlighted several items that need to be considered in future screening programs that will include self-sampling: (1) development of clear user instructions, (2) choice of an effective and acceptable self-sampling device (vaginal or urine), (3) involvement of health professionals, and (4) support for women (information about the sequence of events (collection, results communication, and follow-up of screen-positive patients)). Self-sampling may improve participation in cervical cancer secondary prevention programs by women who do not respond or respond irregularly when invited to contact a health professional for the collection of a cervical specimen. It could also help resolve access problems in areas with a low physician density. The present qualitative study examined barriers to screening, effective screening strategies, and the advantages and disadvantages of sending women urine or vaginal self-sampling kits in two medically underserved administrative departments in France (Mayenne and Sarthe) showing low cervical screening coverage. As part of the CapU4 randomized trial, a team of psychologists investigated the attitudes and experiences of 59 healthcare professionals (gynecologists, general practitioners, and midwives) through semi-structured interviews. Results indicated that health professionals believe that self-sampling may address the issues of low physician density and underscreening by removing logistical, organizational, financial, and psychological obstacles. They confirmed trust in the use of vaginal self-sampling, with urine self-sampling as an alternative solution (e.g., for women with vaginismus). The health professionals also identified several limitations of the self-sampling kit that will need to be addressed in future screening campaigns (incomplete kit, complex instructions, poor anatomical knowledge, and obesity). [ABSTRACT FROM AUTHOR]