B-255 Enhancing HPV Screening and Cervical Cancer Detection in the Asian Community Through Self-Collection

Abstract Background The American Cancer Society’s 2020 guidelines recommend cervical cancer screening for individuals with a cervix aged 25-65 every five years with an HPV test. However, cervical cancer disproportionately affects under-screened populations, including migrant workers, immigrants, and underserved communities. In Oregon, these groups face language, cultural, and healthcare access barriers. To address these challenges, HPV screening must be accessible and culturally sensitive. In May 2024, the FDA approved HPV self-collection using the Cobas HPV Test (Roche Molecular Systems) in healthcare settings. This study aims to evaluate the effectiveness and accessibility of HPV self-collection for underserved communities. Methods This study, approved by the Institutional Review Board at Oregon Health & Science University (OHSU), partnered with the Chinese Friendship Association of Portland (CFAP) to recruit women aged 25-65. Self-collection took place at CFAP’s free clinic, where pathologists guided participants through the process. Participants used Copan swabs (Copan Diagnostics, Murrieta, CA) for vaginal sample collection, which were transferred to ThinPrep media (Hologic, Marlborough, MA) for HPV testing using the Cobas 8800 system (Roche Diagnostics, Pleasanton, CA). Participants also completed questionnaires to provide feedback on the screening process. Results Twenty-eight Asian women, aged 28-62 (mean age 48.3), participated. The group included 1 Vietnamese, 3 from Myanmar, and the rest were Chinese. All self-collection samples were valid; 26 were negative for HPV, and 2 were positive for non-16/18 HPV types. Follow-up Pap smears revealed one normal result and one with atypical squamous cells of undetermined significance. A colposcopy confirmed cervical intraepithelial neoplasia grade 1 in one case, with follow-up recommended in one year. Seventeen participants completed the post-event survey. Four (23.5%) had received the HPV vaccine, and 3 were vaccinated at ages 20–21. When asked about their preference for self-collection, 64.7% of participants were very likely to choose it again, while 29.4% were likely to choose it. Only 5.9% were neutral. Regarding ease of use, 58.8% found the kit very easy, and 29.4% found it easy. Only 5.9% found it difficult. Forty-seven percent found the instructions very clear, while 35.3% felt they were clear. When asked if they would recommend the self-collection method, 58.8% were very likely to recommend it, and 29.4% were likely to recommend it. Feedback from the events was positive, with 41.2% appreciating the convenience and 29.4% praising the friendly, caring staff. Furthermore, 70.6% stated they would not have been able to access screening without the event, highlighting the importance of community-based initiatives. Conclusion This study demonstrates that HPV self-collection is an effective and accessible method for cervical cancer screening, particularly for underserved populations. The high preference for self-collection, positive feedback on ease of use and clarity, and the increased accessibility underscore its potential to improve early detection and reduce cervical cancer incidence in under-screened communities. Additionally, pathologists and laboratory staff play a critical role in leading outreach efforts that not only enhance access to screening but also reduce the overall cost of cervical cancer screening when compared to traditional co-testing and cytology-only methods.