Health  Vol.5 No.12 , December 2013
Acceptability of self-taken vaginal for early detection of HPV DNA in women with limited access to health services: An alternative to increase the coverage in a state of the Mexican Republic

Objective: To determine the acceptability of self-taken vaginal to detect HPV DNA in women living in marginalized areas as an alternative to increase the coverage of health services. Methods: A cross-sectional study from March 2009 to April 2011 in 20 municipalities with the highest marginalization in the Huasteca Region of the State of San Luis Potosi, México. We applied a non-probabilistic quota sampling, which was composed of 608 women aged 25 years and more. The recruitment of women was performed through loudspeakers, leaflets and community meetings. A survey consisted of two sections: socio-demographic data and risk factors, which was validated by construct. We checked the reliability by Cronbach’s Alpha (0.90). Acceptability was determined by considering three indicators: perceived comfort, acceptability of the test and the reasons of acceptability. Results: 41.4% of this woman had 31-40 years. 70.5% were married. 35.3% finished high school and 6.7% had not education experience. 67.4% began their sexual life at 18 years or younger. 85.5% preferred self-collection and 14.5% Pap. These results show a clear acceptability of self-making on the other screening method. Regarding the reason for the preference is that 99.4% of women prefer self-take because they feel more comfortable compared to 0.6% who prefer the Papanicolaou. On the perception of comfort 91% mentioned feel very comfortable with self-making compared with 9% of Pap. There was a statisti

cally significant correlation between preference reasons that women have to choose the screening test and the perception of comfort (X2p = 0.000). Conclusions: The self-taken vaginal HPV DNA detection is a well accepted method in women who live in marginalized areas; therefore, it is an alternative that can be considered in the uterine cancer detection testing program.


Cite this paper: Yolanda, T. , Patricia, M. , Yolanda Graciela, G. , Darío, G. and Sandra Olimpia, G. (2013) Acceptability of self-taken vaginal for early detection of HPV DNA in women with limited access to health services: An alternative to increase the coverage in a state of the Mexican Republic. Health, 5, 2162-2168. doi: 10.4236/health.2013.512295.

[1]   Alterio, G., Mendoza, I., Mendoza, R., Peraza, E., Pérez, H. and Sánchez, A. (2007) Cytological findings and pathology risk factors for preinvasive and invasive cervical cancer. Area of influence of urban ambulatory type II. Revista Public Health and Nutrition, 8, 1-29.

[2]   López, A. and Lizano, M. (2006) Cervical cancer and human papilloma virus that does not end the story. Journal of the National Cancer Institute Mexico, 1, 31-55.

[3]   Castellano, M.R. (2003) Cervical cancer and HPV. Detection options. Revista de la Facultad de Medicina, 46, 63-65.

[4]   Ferlay, J., Bray, F., Pisani, P. and Parkin, D.M. (2000) GLOBOCAN: Cáncer, incidence, mortality and prevalence worldwide. Versión 1.0. IARC Cancer Base No. 5. Lyon: IARC.

[5]   Government of México (2007) National Institute of Statistics, Geography and Informatics. Morbidity and mortality statistics by state. INEGI, Mexico DF.

[6]   Lewis, M.J. (2004) Situational analysis of cervical cancer in Latin America and the Caribbean. Pan American Health Organization/World Health Organization (OPS/ OMS), 1-33.

[7]   Lazcano-Ponce, E.C., Castro, R., Allen, B., Nájera-Aguilar, P., Alonso-de-Ruiz, P. and Hernández-ávila, M. (1999) Barriers to early detection of cervical uterine cancer in Mexico. Journal of Women’s Health, 8, 399-408.

[8]   Cox, J.T., Lorincz, A.T., Schiffman, M.H., Sherman, M.E., Cullen, A. and Kurman, R.J. (1995) Human papillomavirus testing by hybrid capture appears to be useful in triaging women with a cytologic diagnosis of atypical squamous cells of undetermined significance. American Journal of Obstetrics & Gynecology, 172, 946-954.

[9]   Snijders, P. (2011) Milestones in a decision process. HPV Today Newsletter of Human Papillomavirus. Holland Special Edition.

[10]   Gok, M., van Kemenade, F.J., Heideman, D.A., Berkhor, J., Rozendaal, L., Spruyt, J.W., et al. (2010) HPV testing on self-collected cervicovaginal lavage specimens as screening method for women who do not attend cervical screening: Cohort study. BMJ, 340, c1040.

[11]   Sanner, K., Wilkstrom, I., Strand, A., Lindell, M. and Wilander, E. (2009) Self-sampling of the vaginal fluid at home combined with high-risk HPV testing. British Journal of Cancer, 101, 871-874.

[12]   Gok, M., van Kemenade, F.J., Heideman, D.A., Berkhof, J., Rozendaal, L., Spruyt, J.W., et al. (2012) Experience with high-risk human papillomavirus testing on vaginal brush-based self-samples of non-attendees of the cervical screening program. International Journal of Cancer, 130, 1128-1135.

[13]   García Rodríguez, M.C. (2011) Structure, organization and prospects of the State Program for Cervical Cancer. In: Gallegos-García, V., Gutiérrez-Enríquez, S.O., TeránFigueroa, Y. and Velázquez-Mota, G.P., Eds., Experiences in the Implementation of the Programme of Cervical Cancer Screening, Editorial Universidad Autónoma de San Luis Potosí, San Luis Potosí, 33-37.

[14]   Instituto Nacional de Salud Pública (2008) Programme for early detection of cervical cancer with HPV testing: Morelos. Organization and Procedures Manual. Cuernavaca Morelos, 24.

[15]   Khan, M.J., Partridge, E.E., Wang, S.S. and Schiffman, M. (2005) Socioeconomic status and the risk of cervical intraepithelial neoplasia grade 3 among oncogenic human papillomavirus DNA-positive women with equivocal or mildly abnormal cytology. Cancer, 104, 61-70.

[16]   Serrano, R.O., Pérez, C.J.U., Martínez, L.A.D. and Romero, Y.R.D. (2004) Risk factors for uterine cervical cancer. Revista Colombiana de Obstetricia y Ginecología, 55, 146-160.

[17]   álvarez, M., Chiarello, A., Espinal, E., Reigosa, A. and Marrero, M. (2010) Detection of human papillomavirus (HPV) in a group of patients with clinical and/or pathological infection by VPH. Salud Rev de la Facultad de Ciencias de la Salud. Universidad de Carabobo, 4, 19-26.

[18]   Torres-Poveda, K.J., Arredondo-López, A.A., Duarte-Gómez, M.A. and Madrid-Marina, V. (2008) The indigenous women vulnerable to cervical cancer: Perspectives from conceptual models of public health. Revista Salud en Tabasco, 14, 807-815.

[19]   Heideman, D.A.M. (2012) Auto-sampling in cervical screening programs: Current practice to future practice. HPV Today Newsletter of Human Papillomavirus, Holland Special Edition, 24, 10-11.

[20]   Szarewski, A., Cadman, L., Mesher, D., Austin, J., Ashdown-Barr, L., Edwards, R., Lyons, D., et al. (2011) HPV self-sampling as an alternative strategy in non-attenders or cervical screening: A randomised controlled trial. British Journal of Cancer, 104, 915-920.

[21]   Harper, D.M. (2004) Self-sampling for HPV: What method to use? Today Newsletter of Human Papillomavirus, 5, 12.

[22]   Sankaranarayanan, R. (2011) Prevention of mortality from cervical cancer in rural India: The value of an HPV test. HPV Today Newsletter of Human Papillomavirus, 23, 1-3.