Randomized experimental population-based study to evaluate the acceptance and completion of and preferences for cervical cancer screening

TL;DR

This study explores how different cervical cancer screening methods are accepted and completed by women in Brazil, finding that home-based options may improve participation.

Contribution

The study introduces a community trial comparing four cervical cancer screening methods and a choice-based group to assess acceptance and completion rates.

Findings

Methods allowing sampling near the home (urine and vaginal self-collection) had high acceptance rates.

Only 84% of eligible women completed the collection step, indicating challenges in follow-through.

Women’s choice group preferred hospital-based exams over self-collection methods.

Abstract

Cervical cancer has high incidence and mortality rates, especially in less-developed countries. Prevention methods are well established, but there are still barriers preventing some Brazilian women from undergoing a Pap sample. The objective of the study was to evaluate the acceptance, preferences and completion of four screening methods. This has an experimental design (community trial). A total of 164 participants who had never had a Pap sample or had not had one for more than three years were included. The city’s urban area was stratified by census tracts and divided according to income and education levels. Women belonging to the lower-income strata were considered in the study. Random blocks were numbered into five intervention groups (Group 1- Pap sample at the hospital; Group 2- Pap sample in the mobile unit; Group 3- urine self-collection; Group 4- vaginal self-collection; Group 5- woman’s choice). Only 164 women met all of the eligibility criteria (15.3%). Most of them accepted the assigned method (92%), but only 84% of the women completed the collection step. The acceptance rates were as follows: Group 1 (100%), Group 2 (64.5%), Group 3 (100%) and Group 4 (91.4%). In Group 5, the women’s preferences were distributed as follows: examination performed at the hospital, 13 women (33.3%); examination performed at the mobile unit, 11 women (28.2%); urine self-collection, 11 women (28.2%); and vaginal self-collection, 4 women (10.3%). This study suggests that methods that allow cervical sampling collected near the women’s domicile might improve the acceptance and completion of preventive tests. This finding is relevant for the development of new cervical cancer screening strategies.

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