Selda Songur Dağlı
HPV self-sampling was highly acceptable among women with actual self-sampling experience; however, favorable experiences did not necessarily translate into a preference for self-sampling in future screening. Educational level was associated with screening preference, although the modest explanatory power of the model suggests that additional factors may influence women's choices. HPV self-sampling may therefore be most appropriately considered as a complementary screening option that preserves patient choice rather than as a universal replacement for clinician-based screening.
BACKGROUND: Human papillomavirus (HPV) self-sampling has emerged as a potential alternative approach for cervical cancer screening. However, limited evidence is available regarding women's experiences and future screening preferences following actual self-sampling.
OBJECTIVE: To evaluate women's real-life experiences with HPV self-sampling and identify factors associated with future screening preferences in a Turkish population with actual self-sampling experience.
METHODS: This cross-sectional, interview-based study was conducted at the Obstetrics and Gynecology Outpatient Clinic of Kırşehir Training and Research Hospital, Türkiye, between July 2025 and May 2026. HPV self-sampling was offered to 850 eligible women aged 30-65 years, of whom 500 voluntarily accepted and completed self-sampling and subsequent face-to-face interviews (participation rate, 58.8%). Experiences and future screening preferences were assessed using a culturally adapted questionnaire based on the Theoretical Framework of Acceptability. Multivariable binary logistic regression with backward likelihood-ratio selection was used to identify factors associated with preference for clinician-based screening.
RESULTS: Participants reported highly favorable experiences with HPV self-sampling: 81.0% rated the experience as good or very good, 83.8% felt moderately or very confident in performing the test correctly, and 80.2% considered the procedure moderately or very easy to perform. Nevertheless, 49.6% preferred clinician-based screening for future cervical cancer screening, whereas 46.2% preferred HPV self-sampling at home and 4.2% were undecided. Higher educational level was significantly associated with a lower likelihood of preferring clinician-based screening compared with primary school education (high school: OR=0.355, 95% CI: 0.213-0.593; university: OR=0.326, 95% CI: 0.190-0.558; both p<0.001), whereas age was not significantly associated with screening preference. The final model had modest explanatory power (Nagelkerke R2=0.093).
CONCLUSION: HPV self-sampling was highly acceptable among women with actual self-sampling experience; however, favorable experiences did not necessarily translate into a preference for self-sampling in future screening. Educational level was associated with screening preference, although the modest explanatory power of the model suggests that additional factors may influence women's choices. HPV self-sampling may therefore be most appropriately considered as a complementary screening option that preserves patient choice rather than as a universal replacement for clinician-based screening.