HPV Self-sampling to Improve Access to Cervical Cancer Screening at a Women's Health Clinic in Anchorage, Alaska

Abstract

Purpose: The purpose of this quality improvement (QI) project was to evaluate the acceptability of HPV self-sampling for cervical cancer screening for rural Alaskan women at a community-based clinic. Background: Over 91% of cervical cancer diagnoses are caused by persistent high-risk human papillomavirus infection. Regular and timely screening has been shown to reduce the prevalence for cervical cancer, however, there are barriers that may limit access to screening resources. Traditionally, cervical cancer screening requires in-person clinic visits where a provider will perform a Pap test. There is emerging scholarly research on the use of HPV self-sampling for cervical cancer screening which would reduce or eliminate the need for women to attend in-person screening. Method: The PDSA model was used as a framework to guide the plan for implementation and data analysis. The design of this one-month project was a pre- and post-survey which was sent through the participant’s email and a self-sampling intervention that was mailed directly to the participants for them to complete and return in the mail. Participants were recruited through the electronic medical record at Women’s Care of Alaska which is an outpatient obstetrics and gynecology clinic in Anchorage, Alaska. Results: Fourteen participants were sent HPV self-sampling kits. Twelve participants responded to the pre-survey and nine participants responded to the post-survey. Of the nine post-survey responses, eight of the participants completed and returned the kit in the mail. Seven out of eight of the participants who completed and returned their kit would choose self-sampling over in-person Pap testing if given the choice (87.5%). The consensus from the post-survey is that self-sampling for HPV is highly accepted by participants as an option for cervical cancer screening. Conclusion: The implementation was successful, as evidenced by the positive feedback from the participants. HPV self-sampling is a promising evidence-based resource to improve access to cervical cancer screening, however, it requires further research and guideline recommendations.