Acceptability Of HPV Self-Sampling For Cervical Cancer Screening In An Indigenous Community In Guatemala

Rafael MEZA, University of Michigan, United States
GOTTSCHLICH A. 1 , RIVERA-ANDRADE A. 2 , MENDOZA-MONTANO C. 2,3 , GRAJEDA E. 4 , ALVAREZ C. 1

1 Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
2 Institute of Nutrition of Central America and Panama-INCAP, Guatemala City, Guatemala
3 Faculty of Medical Sciences and Health, Universidad Mariano Galvez de Guatemala, Guatemala City, Guatemala
4 School of Medicine and Surgery, Universidad Rafael Landivar, Guatemala City, Guatemala

Purpose: Rates of cervical cancer in Latin America are higher than those in developed countries, likely due to low prevalence of screening.  Specifically, the screening rates are particularly low in indigenous communities in Guatemala.  Current screening strategies, Pap smears and Visual Inspection With Acetic Acid (VIA), might not be the most effective methods for controlling cancer in these settings. So we investigated the potential of self-collection of vaginal specimens for human papillomavirus (HPV) testing for cervical cancer prevention.
Methods:  A community representative random sample of 202 women aged 18-60 who resided in Santiago Atitlan, an indigenous community in Guatemala, were surveyed during July 2015 to assess knowledge of and risk factors for HPV.  Women then collected a vaginal sample for HPV testing to assess infection prevalence and acceptability of self-sampling as an alternative screening method.
Results: Of 202 women who completed the survey, 178 (88%) provided a sample.  After collection, 100% reported they were willing to perform this test periodically as a method of screening. 31 (17%) samples tested positive for at least one of 13 high-risk HPV types. 8 samples (4.5%) were positive for HPV 16/18.  
Conclusions: Self-collection HPV testing was very well accepted in this community, suggesting it is a plausible alternative modality for cervical cancer screening.  Further studies are needed to assess rates of follow-up screening after receiving a positive result on an HPV test and determine if these results extend to other indigenous and non-indigenous communities in Guatemala and Latin America.