Indigenous Latin American women prefer taking a test for cervical cancer at home by themselves rather than in a medical facility, a study of a Guatemala community shows.
Cervical cancer is a disease associated with the human papilloma virus (HPV) that is preventable if detected in time. But it is one of the leading causes of death among women in Latin America, particularly in indigenous communities.
Guatemala women living in indigenous communities often have poor access to hospitals and healthcare facilities where they could get traditional HPV screenings, or PAP smears.
A University of Michigan-led study indicates they could fight cervical cancer by taking self-tests, then following up with healthcare professionals.
The study, “Acceptability of Human Papillomavirus Self-Sampling for Cervical Cancer Screening in an Indigenous Community in Guatemala,” was published in the Journal of Global Oncology.
Self-tests could be particularly important for indigenous Guatemalan women because estimates are that only 40 percent have been tested for cervical cancer, the researcher said.
“In our community-based cross sectional study, we found that women from the indigenous community of Santiago Atitlan were fairly open to trying HPV self-sampling (a vaginal self-swab),”Anna Gottschlich, the doctoral student at the University of Michigan’s School of Public Health who led the study, said in a press release. “And that after trying it, they considered it to be a much preferred alternative than the Pap smear.”
Gottschlich led the study in Santiago Atitlan, which is a Mayan indigenous community of 45,000. Researchers gave questionnaires to 212 women, aged 18 to 60, from nine neighborhoods. The 143-item survey included questions about preventive health and HPV, as well as cervical cancer.
Only 15 percent of the women interviewed reported knowing about HPV. Ninety-three percent said they wanted to learn more and were willing to collect self-samples.
Women who were having a period or were pregnant were considered ineligible for the tests, which reduced the sample size to 89 percent of those who showed interest.
Seventy-nine percent of those eligible reported feeling comfortable with the test, 91 percent found it easy to use, and all were willing to perform the test periodically as a screening method. Seventeen percent of the women tested positive for at least one of the 13 types of HPV associated with cervical cancer.
“The results were amazing,” said lead senior researcher Rafael Meza, at assistant professor of epidemiology at the University of Michigan’s School of Public Health. “The acceptability was extremely high. Almost 100 percent wanted to try. And most found it comfortable and easy to do and 100 percent would prefer (the self-collection) to pap smears.”
Researchers are now doing follow-up studies in two rural communities in Guatemala. They want to compare rates of follow-up care among women who tested positive for HPV with follow-up rates of other types of screenings. That will help them determine whether self-screening is a good way to go.
“We hope that our study, along with future evidence, will help local and regional authorities identify the best cervical cancer screening alternative for their own settings,” Meza said.