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Self-Collection and HPV Testing in Unscreened Women: A Feasibility Study in Brazil

Isabel Scarinci

6 Collaborator(s)

Although Papanicolaou (Pap)-based screening programs are widely available in low- and middle-income countries, some women do not fully participate in these programs due to structural and intra/interpersonal barriers, resulting in higher cervical cancer incidence and mortality compared to high-income countries. HPV DNA testing has been shown to be effective for cervical cancer screening, and self-collected sampling at home (“self-collection”) with HPV testing could be a potential alternative to Pap test among women who are not currently engaging in cervical cancer screening. The purpose of this feasibility study is to compare three cervical cancer screening modalities (self-collection and HPV testing, Pap testing at the public health clinic, and choice between self-collection and HPV testing and Pap testing) among women who have not undergone cervical cancer screening within the past four years using a theory-based, culturally relevant intervention implemented by Community Health Workers (CHWs) via door-to-door visits. Three Basic Health Units (BHUs) within the public health system in Maringá, Paraná, Brazil will be randomly assigned to one of the three screening modalities/conditions. CHWs will invite women who report not having been screened for cervical cancer in the past four years to participate in the study, and deliver a brief educational/behavioral session on cervical cancer and screening using a door-to-door approach under of one of the three conditions. The primary outcome will be adherence to cervical cancer screening.