Women’s preferences for HPV self-sampling in cervical cancer screening: a discrete choice experiment

Background: HPV self-sampling can increase cervical cancer screening coverage. To effectively implement this innovative screening method, it is crucial to gain an in-depth understanding of women's acceptance and preferences regarding each stage of the HPV self-sampling intervention process. This study aims to identify the key attributes of HPV self-sampling that drive acceptance among under-screened populations, thereby informing the development of equitable screening strategies that reduce barriers and expand access to cervical cancer prevention. Methods: In this cross-sectional study, we conducted a Discrete Choice Experiment (DCE) between 1 September 2024 and 31 March 2025, assessing preferences for five attributes of HPV self-sampling: accuracy, procedural difficulty, comfort, sampling time, and price. Analyses employed a mixed logit model, adhering to the Discrete Choice Experiment Reporting Checklist (DIRECT) reporting guideline. We estimated relative importance (RI) for each attribute, derived willingness-to-pay (WTP), and examined preference heterogeneity using interaction terms. Results: < 0.05). Conclusion: Accuracy, price, and sampling time are the dominant drivers of women's choices for HPV self-sampling, and are simultaneously significantly moderated by individual characteristics such as age, ethnicity, education, and sampling preference. These findings underscore that effective screening programs must not only optimize core product attributes but also develop tailored strategies to address the distinct preferences of different demographic subgroups.