Primary study on providing a basic system for uterine cervical screening in a developing country: analysis of acceptability of self-sampling in Lao PDR

Asian Pac J Cancer Prev. 2013;14(5):3029-35. doi: 10.7314/apjcp.2013.14.5.3029.

Abstract

Background: Most developing countries have been unable to implement well-organized health care systems, especially comprehensive Pap smear screening-based programs. One of the reasons for this is regional differences in medical services, and a low-cost portable cervical screening system is necessary. To improve regional discrepancies in cervical screening systems, we investigated the usefulness and acceptability of cervical self- sampling by liquid-based cytology (LBC) for 290 volunteers in the Lao PDR.

Materials and methods: Following health education with comprehensive documents, cervical self-sampling kits by LBC were distributed in three provincial, district, and village areas to a total of 290 volunteers, who were asked to take cytology samples by themselves. Subsequently, the acceptability of self-sampling was evaluated using a questionnaire.

Results: The documents were well understood in all three regions. Regarding the acceptability of self-sampling, the selections for subsequent screening were 62% self-sampling, 36% gynecologist-sampling, 1% either method, and 1% other methods. The acceptability rates were higher in the district and the village than in the province. For the relationship between acceptability and pregnancy, the self-sampling selection rate was higher in the pregnancy-experienced group (75%) than in the pregnancy-inexperienced group (60%). For the relationship between selection of self-sampling and experience of screening, the self-sampling selection rate was higher in the screening-inexperienced group (62%) than in the screening-experienced group (52%).

Conclusions: Our data show that this new way forward, involving a combination of self-sampling and LBC, is highly acceptable regardless of age, educational background, and residence in rural areas in a developing country.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Developing Countries
  • Female
  • Follow-Up Studies
  • Health Education
  • Humans
  • Mass Screening*
  • Middle Aged
  • Papanicolaou Test
  • Papillomaviridae / isolation & purification*
  • Papillomavirus Infections / diagnosis
  • Papillomavirus Infections / prevention & control*
  • Papillomavirus Infections / virology
  • Pregnancy
  • Prognosis
  • Specimen Handling
  • Surveys and Questionnaires
  • Uterine Cervical Neoplasms / diagnosis
  • Uterine Cervical Neoplasms / prevention & control*
  • Uterine Cervical Neoplasms / virology
  • Vaginal Smears
  • Young Adult