Table 3.
Reasons limiting the acceptance of HPV self-sampling.
| Country, Authors | Reasons to not accept HPV self-sampling or other screening test |
|---|---|
| Argentina, Arrossi et al. [22] | Insecurity in their ability to correctly use the self-sampling test |
| Possibility of self-injury using the self-sampling test | |
| Fear of contaminating the sample | |
| Lack of confidentiality in healthcare facilities | |
| Perception of the health-disease status defined as the absence or presence of symptoms (pain, inflammation, or vaginal discharge) | |
| Lack of interest in their health | |
| The possibility that screening could result in cancer diagnosis frightened women | |
| The belief that cancer is a dormant disease that can be awaken by introducing a sample-taking device in the vagina or cervix | |
| Bolivia, Surriabre et al. [23] | NR |
| Bolivia, Allende et al. [24] | NR |
| Brazil, Lorenzi et al. [25] | Fear of self-injury using the self-sampling test |
| Discomfort or pain using the self-sampling test | |
| Chile, Léniz et al. [26] | Lack of interest (38.2%) |
| Preference to attend health center (26.5%) | |
| Fear of the procedure (19.6%) | |
| Lack of time (15.7%) | |
| Colombia, Torrado-Garcia et al. [27] | NR |
| El Salvador, Rosenbaum et al. [28] | Result accuracy (33.3%) |
| Provider’s knowledge confidence (24.2%) | |
| Confidence in the provider's expertise in performing the test (16.4%) | |
| Fear of improper sampling (13.3%) | |
| Comfort (33.0%) | |
| The availability of assistance/equipment (25.2%) | |
| The sanitation of the facilities (12.4%) | |
| Privacy (11.0%) | |
| El Salvador, Laskow et al. [29] | Disinterest to be screened (p = 0.001) |
| Belief that the results might not be correct | |
| Discomfort with touching themselves (p = 0.001) | |
| Felt embarrassed by self-sampling (p = 0.001) | |
| Preferred that a clinician take the sample (p = 0.001) | |
| Not having the time or privacy in their own home (p = 0.001) | |
| Perception to be at low risk of cervical cancer to not have symptoms | |
| El Salvador, Maza et al. [30] | Were embarrassed at being seen by a male physician (55.6%) * |
| Lack of symptoms (38.9%) * | |
| Belief that the test was not necessary (27.5%) * | |
| Long clinic waits times (22.5%) * | |
| Belief that the screening would be painful (27.1%) * | |
| Fear that treatment would be needed (20.5%) * | |
| Belief that tests results would not be kept confidential (20.1%) * | |
| Fear that the person might lose part of the uterus during treatment (22.9%) * | |
| Guatemala, Gottschlich et al. [31] | NR |
| Guatemala, Murchland et al. [32] | NR |
| Mexico, Dzuba et al. [33] | More confidence in the Pap test (93.1%) |
| Nicaragua, Quincy et al. [34] | More confident of the result from clinician-sampling |
| Peru, Morán et al. [35] | Fear of knowing they are diseased |
| Confidence that self-sampling will be administered correctly | |
| Distrust in the validity of self-sampling results | |
| Puerto Rico, Ortiz et al. [36] | More confident that the sample would be more properly taken (85.6%) |
NR: Not reported.
* Reasons for not attending a cervical cancer screening appointment.