Presentation (CTI)

OBJECTIVES: The NHS Cervical Screening Programme currently involves a healthcare professional collecting a cervical human papillomavirus (HPV) sample in a clinical setting. There are limitations to this approach, including difficulty in accessing appointments and the discomfort caused by speculum examinations. The introduction of HPV testing has enabled the development of self-sampling methods, including vaginal and urine collection. While the accuracy of these methods has been studied, it remains unclear which features of self-sampling influence preferences, acceptability, and uptake. This study aims to quantify preferences for cervical screening features among women eligible for cervical screening in the UK.
METHODS: A discrete choice experiment was conducted (N=1,129). The survey included 8 choice tasks per participant, asking them to choose between two potential screening options, or no screening. Screening features varied across options and included detection rate (80% to 95%), sampling method (clinician‑collected or self‑sampling options), location, level of pain (none to severe), contact with the clinician, and screening frequency (annual to every five years). Results were analysed using conditional logit, random parameter logit and latent class models, and uptake calculated.
RESULTS: Overall, participants preferred screening over no screening, with higher detection rates, vaginal and urine samples compared to the smear test, and the test being conducted at home compared to a healthcare setting. Participants disliked severe pain and screening every 5 years compared to yearly. No significant preferences (P>0.05) were found for the level of contact with the clinician. Uptake ranged from 38% to 99.5%, depending on class membership (defined by previous screening attendance, pain during testing and perceived risk) and screening programme design.
CONCLUSIONS: There are differing preferences for sample collection across the population, influenced by perceived risk of cervical cancer and previous screening experience. These results can be used to guide the design of the cervical screening programme in the UK.