Exploring the Feasibility of Using Self-Sampling for HPV E6/E7 mRNA Detection in Cervical Cancer Screening Programs

Objective:

To investigate the awareness, acceptance, and user experience of self-sampling for high-risk human papillomavirus (HPV) E6/E7 mRNA detection among Chinese women, and to explore its feasibility for integration into cervical cancer screening programs.

Methods:

A multi-center cross-sectional questionnaire survey was conducted across five hospitals in China from March 2023 to April 2024 among women participating in a related accuracy study. A total of 809 eligible women were recruited, and 737 completed questionnaires were included in the analysis (effective response rate: 97.62%). The self-administered questionnaire assessed demographic characteristics, awareness of cervical cancer screening, acceptance of self-sampling (including preferences, concerns, motivations, and willingness to pay), and user experience. Statistical analyses involved chi-square or non-parametric tests to examine associations between key demographic factors (age, education, and monthly income) and outcomes of interest.

Results:

The participants were predominantly aged 30–45 years (57.94%), with 46.67% holding a bachelor's degree or above. Awareness of screening was high, with 78.02% having undergone a gynecological examination within the past year. Acceptance of self-sampling was high: 95.93% were willing to use it, 93.49% found the process comfortable, and 99.19% reported understanding of the instructional materials. However, demographic factors significantly influenced perceptions. Higher education and income levels were associated with greater willingness to pay and a stronger emphasis on privacy as a motivation. In contrast, individuals with lower education and income levels reported more concerns about difficulty performing the sampling procedure and were more likely to rely on hospital-based health education for information. Key concerns included test reliability (22.39%) and sampling safety (21.71%).

Conclusion:

Self-sampling for cervical cancer screening using HPV E6/E7 mRNA testing is highly acceptable among urban Chinese outpatients and is valued for its convenience and privacy. However, acceptance varies significantly by age, education, and income, underscoring the need for population-specific implementation strategies to ensure equitable screening access.

The clinical trial registration number is: Chinese Clinical Trial Registry (ChiCTR2200056212).