The acceptability of a self-lavaging device compared to pelvic examination for cervical cancer screening among low-income women

J Womens Health (Larchmt). 2012 Dec;21(12):1275-81. doi: 10.1089/jwh.2012.3512. Epub 2012 Aug 20.


Background: A simpler approach to cervical cancer screening could increase coverage, thus reducing cervical cancer mortality in the United States. Self-collection of specimens for screening tests may be one such approach. The aim of this study was to assess the acceptability of a self-lavaging device (Delphi Screener(™), Scherpenzeel, The Netherlands) for cervical cancer screening. Self-lavage specimens have been shown to have equivalent sensitivity for detection of high-grade cervical intraepithelial neoplasia (CIN) when coupled with high-risk human papillomavirus (HPV) tests as clinician-collected specimens with cytologic review.

Methods: Low-income women (n=198) who had recently received cervical cytologic testing in one of three participating clinics in New York City enrolled; 197 self-lavaged. Women answered open-ended and closed-ended questions on ease of use, level of comfort with the self-lavage and the pelvic examination, and future screening preference.

Results: Ninety-six percent of women reported they were very/somewhat comfortable self-lavaging compared to 47% very/somewhat comfortable with the clinician collecting a specimen during a pelvic examination (p<0.001). The majority (79%) would prefer self-lavage the next time they need to be screened; only 8% would prefer pelvic examination by a doctor, and 14% had no preference. The main reasons for preferring self-lavage centered on convenience and comfort.

Conclusions: Self-lavaging was highly acceptable to women in this study. Self-collection of specimens has the potential to simplify screening and reduce logistical barriers for many women, which could increase overall coverage of cervical cancer screening.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cervix Uteri / virology
  • Early Detection of Cancer
  • Female
  • Humans
  • Income
  • Middle Aged
  • New York City
  • Pain Measurement
  • Papillomaviridae / isolation & purification*
  • Papillomavirus Infections / diagnosis*
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Self Care / methods*
  • Socioeconomic Factors
  • Specimen Handling / methods
  • Surveys and Questionnaires
  • Uterine Cervical Dysplasia / diagnosis*
  • Uterine Cervical Dysplasia / virology
  • Vaginal Douching
  • Vaginal Smears / methods