Women’s reasoning and experience in the cervical cancer screening programme when offered a self-sampling HPV test: a qualitative content analysis

BACKGROUND: Our aim was to explore the reasoning and experiences of women when offered a self-sampling HPV test. METHODS: This study implemented a qualitative study design and content analysis using an inductive approach. Data consisted of written narratives collected through open-ended questions from a total of 173 women. Women were included if they had been offered a self-sampling device since September 2021 and were southern Sweden residents. To achieve purposive sampling with maximum variation, attenders adhering to the screening programme, nonattenders (absent for at least two screening rounds), and women with cervical dysplasia were recruited. RESULTS: The content analysis generated seven categories: (1) unpleasant experience with a vaginal examination; (2) gratefulness and acceptability of self-sampling; (3) varied perception of one's capacity to perform self-sampling; (4) preference for cervical sampling by healthcare professionals; (5) anxiety and fear concerning a potential or detected HPV infection; (6) different risk assessments for acquiring an HPV infection; and (7) negative impact on mental well-being due to cervical dysplasia. The overarching theme became "the HPV self-sampling reduced practical and emotional barriers to attending the cervical cancer screening programme, but test results may create anxiety." CONCLUSIONS: Most women valued HPV self-sampling, although their confidence in performing it varied. Self-sampling can reduce the emotional and practical barriers to participation in cervical cancer screening. However, anxiety about cervical dysplasia or following a positive HPV test was noted, highlighting the need for healthcare professionals to provide personalised information to alleviate negative emotions.