{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:58:58Z","timestamp":1790312338224,"version":"4.1.0"},"reference-count":33,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2022,5,26]],"date-time":"2022-05-26T00:00:00Z","timestamp":1653523200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Canadian Institutes for Health Research","award":["MCT-82072"],"award-info":[{"award-number":["MCT-82072"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Self-collection may provide an opportunity for innovation within population-based human papillomavirus (HPV) cervical cancer screening programs by providing an alternative form of engagement for all individuals. The primary objective was to determine willingness to self-collect a vaginal sample for primary HPV screening and factors that impact willingness in individuals who participated in the Human Papillomavirus For Cervical Cancer (HPV FOCAL) screening trial, a large randomized controlled cervical screening trial. A cross-sectional online survey was distributed between 2017 and 2018 to 13,176 eligible participants exiting the FOCAL trial. Bivariate and multivariable logistic regression assessed factors that influence willingness to self-collect on 4945 respondents. Overall, 52.1% of respondents indicated willingness to self-collect an HPV sample. In multivariable analysis, the odds of willingness to self-collect were significantly higher in participants who agreed that screening with an HPV test instead of a Pap test was acceptable to them (odds ratio (OR): 1.45 (95% confidence interval (CI): 1.15, 1.82), those who indicated that collecting their own HPV sample was acceptable to them (p &lt; 0.001), and those with higher educational ascertainment (OR: 1.31, 95% CI: 1.12, 1.54). The findings offer insight into the intentions to self-collect in those already engaged in screening, and can inform cervical cancer screening programs interested in offering alternative approaches to HPV-based screening.<\/jats:p>","DOI":"10.3390\/curroncol29060308","type":"journal-article","created":{"date-parts":[[2022,5,26]],"date-time":"2022-05-26T08:50:22Z","timestamp":1653555022000},"page":"3860-3869","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Willingness to Self-Collect a Sample for HPV-Based Cervical Cancer Screening in a Well-Screened Cohort: HPV FOCAL Survey Results"],"prefix":"10.3390","volume":"29","author":[{"given":"Anne","family":"Lesack","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurie W.","family":"Smith","sequence":"additional","affiliation":[{"name":"Cancer Control Research, BC Cancer, Vancouver, BC V5Z 1L3, Canada"},{"name":"Women\u2019s Health Research Institute, BC Women\u2019s Hospital, Vancouver, BC V6H 3N1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Sarai","family":"Racey","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada"},{"name":"Women\u2019s Health Research Institute, BC Women\u2019s Hospital, Vancouver, BC V6H 3N1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lovedeep","family":"Gondara","sequence":"additional","affiliation":[{"name":"Cancer Surveillance and Outcomes, BC Cancer, Vancouver, BC V5Z 4E6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mel","family":"Krajden","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada"},{"name":"Public Health Laboratory, BC Centre for Disease Control, Vancouver, BC V5Z 4R4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marette","family":"Lee","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada"},{"name":"Cervix Screening Program, BC Cancer, Vancouver, BC V5Z 4E6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth Elwood","family":"Martin","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8815-4607","authenticated-orcid":false,"given":"Gavin","family":"Stuart","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8243-8721","authenticated-orcid":false,"given":"Stuart","family":"Peacock","sequence":"additional","affiliation":[{"name":"Cancer Control Research, BC Cancer, Vancouver, BC V5Z 1L3, Canada"},{"name":"Faculty of Health Sciences, Simon Fraser University, Vancouver, BC V5A 1S6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4409-8084","authenticated-orcid":false,"given":"Eduardo L.","family":"Franco","sequence":"additional","affiliation":[{"name":"Division of Cancer Epidemiology, Faculty of Medicine, McGill University, Montreal, QC H4A 3T2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"van Niekerk","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada"},{"name":"Cervix Screening Program, BC Cancer, Vancouver, BC V5Z 4E6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gina S.","family":"Ogilvie","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada"},{"name":"Women\u2019s Health Research Institute, BC Women\u2019s Hospital, Vancouver, BC V6H 3N1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.ygyno.2008.07.045","article-title":"Natural history and epidemiology of HPV infection and cervical cancer","volume":"110","year":"2008","journal-title":"Gynecol. Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1002\/(SICI)1096-9896(199909)189:1<12::AID-PATH431>3.0.CO;2-F","article-title":"Human Papillomavirus Is a Necessary Cause","volume":"189","author":"Walboomers","year":"1999","journal-title":"J. Pathol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.1016\/j.jogc.2018.05.024","article-title":"A Review of the Impact and Effectiveness of the Quadrivalent Human Papillomavirus Vaccine: 10 Years of Clinical Experience in Canada","volume":"40","author":"Steben","year":"2018","journal-title":"J. Obstet. Gynaecol. Can."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Ferrer, H.B., Trotter, C., Hickman, M., and Audrey, S. (2014). Barriers and facilitators to HPV vaccination of young women in high-income countries: A qualitative systematic review and evidence synthesis. BMC Public Health, 14.","DOI":"10.1186\/1471-2458-14-700"},{"key":"ref_5","unstructured":"WHO (2021, May 25). Primary and Secondary Prevention of Cancer: Response by Country. Available online: https:\/\/apps.who.int\/gho\/data\/view.main.24766."},{"key":"ref_6","unstructured":"BC Cancer, and van Niekerk, D. (2021, May 24). BC Cancer Cervix Screening Program Overview. Available online: http:\/\/www.bccancer.bc.ca\/screening\/Documents\/Cervix-Program-Overview.pdf."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1001\/jama.2018.7464","article-title":"Effect of screening with primary cervical HPV testing vs cytology testing on high-grade cervical intraepithelial neoplasia at 48 months: The HPV FOCAL randomized clinical trial","volume":"320","author":"Ogilvie","year":"2018","journal-title":"JAMA\u2014J. Am. Med. Assoc."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.1056\/NEJMoa071430","article-title":"Human Papillomavirus DNA versus Papanicolaou Screening Tests for Cervical Cancer","volume":"357","author":"Mayrand","year":"2007","journal-title":"N. Engl. J. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/S1470-2045(13)70570-9","article-title":"Accuracy of human papillomavirus testing on self-collected versus clinician-collected samples: A meta-analysis","volume":"15","author":"Arbyn","year":"2014","journal-title":"Lancet Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1016\/j.ygyno.2007.01.023","article-title":"Are self-collected samples comparable to physician-collected cervical specimens for human papillomavirus DNA testing? A systematic review and meta-analysis","volume":"105","author":"Petignat","year":"2007","journal-title":"Gynecol. Oncol."},{"key":"ref_11","unstructured":"Australian Government D of H (2021, June 10). Quick Reference Guide\u2014Self-Collected Vaginal Sample for HPV Test, Available online: https:\/\/www.health.gov.au\/sites\/default\/files\/documents\/2019\/10\/national-cervical-screening-program-quick-reference-guide-self-collected-cervical-screening-tests.pdf."},{"key":"ref_12","unstructured":"RIVM: National Institute For Public Health and the Environment (2022, April 26). Cervical Cancer Screening Program. Available online: https:\/\/www.rivm.nl\/en\/cervical-cancer-screening-programme."},{"key":"ref_13","unstructured":"Regionala Cancercentrum I Samverkan (2021, June 10). National Care Program Cervical Cancer Prevention. Available online: https:\/\/kunskapsbanken.cancercentrum.se\/diagnoser\/livmoderhalscancerprevention\/vardprogram\/."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1503\/cmaj.070013","article-title":"Feasibility of self-collection of specimens for human papillomavirus testing in hard-to-reach women","volume":"177","author":"Ogilvie","year":"2007","journal-title":"Can. Med Assoc. J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"k4823","DOI":"10.1136\/bmj.k4823","article-title":"Detecting cervical precancer and reaching underscreened women by using HPV testing on self samples: Updated meta-analyses","volume":"363","author":"Arbyn","year":"2018","journal-title":"BMJ"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1097\/LGT.0000000000000476","article-title":"Acceptability of Women Self-Sampling versus Clinician-Collected Samples for HPV DNA Testing: A Systematic Review","volume":"23","author":"Morgan","year":"2019","journal-title":"J. Low Genit. Tract. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1136\/sextrans-2017-053235","article-title":"Acceptability and ease of use of mailed HPV self-collection among infrequently screened women in North Carolina","volume":"94","author":"Anderson","year":"2017","journal-title":"Sex. Transm. Infect."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1917","DOI":"10.1038\/bjc.2012.489","article-title":"Primary cervical cancer screening with HPV testing compared with liquid-based cytology: Results of round 1 of a randomised controlled trial\u2014The HPV FOCAL Study","volume":"107","author":"Ogilvie","year":"2012","journal-title":"Br. J. Cancer"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Ogilvie, G.S., Van Niekerk, D.J., Krajden, M., Martin, R.E., Ehlen, T.G., Ceballos, K., Peacock, S.J., Smith, L.W., Kan, L., and Cook, D.A. (2010). A randomized controlled trial of Human Papillomavirus (HPV) testing for cervical cancer screening: Trial design and preliminary results (HPV FOCAL Trial). BMC Cancer, 10.","DOI":"10.1186\/1471-2407-10-111"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Smith, L.W., Khurshed, F., Van Niekerk, D.J., Krajden, M., Greene, S.B., Hobbs, S., Coldman, A.J., Franco, E.L., and Ogilvie, G.S. (2014). Women\u2019s intentions to self-collect samples for human papillomavirus testing in an organized cervical cancer screening program. BMC Public Health, 14.","DOI":"10.1186\/1471-2458-14-1060"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e052084","DOI":"10.1136\/bmjopen-2021-052084","article-title":"Women\u2019s acceptability of and experience with primary human papillomavirus testing for cervix screening: HPV FOCAL trial cross-sectional online survey results","volume":"11","author":"Smith","year":"2021","journal-title":"BMJ Open"},{"key":"ref_22","unstructured":"AAPOR (2016). Standard Definitions: Final Dispositions of Case Codes and Outcome Rates for Surveys, American Association for Public Opinion Research. [9th ed.]."},{"key":"ref_23","unstructured":"R Core Team (2020). R: A Language and Environment for Statistical Computing, R Foundation for Statistical Computing. Available online: https:\/\/www.r-project.org\/."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e001351","DOI":"10.1136\/bmjgh-2018-001351","article-title":"Self-sampling for human papillomavirus (HPV) testing: A systematic review and meta-Analysis","volume":"4","author":"Yeh","year":"2019","journal-title":"BMJ Glob. Health"},{"key":"ref_25","unstructured":"BC Cancer (2021, July 05). BC Cancer Cervix Screening 2018 Program Results. Available online: http:\/\/www.bccancer.bc.ca\/screening\/Documents\/Cervix_ProgramResults2016_OPT.pdf."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1097\/00128360-200304000-00007","article-title":"Patient Acceptance of Self-Sampling for Human Papillomavirus in Rural China","volume":"7","author":"Tisci","year":"2003","journal-title":"J. Low. Genit. Tract Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1089\/jwh.2005.14.721","article-title":"Acceptability of self-collection of specimens for HPV DNA testing in an urban population (Abstract)","volume":"14","author":"Anhang","year":"2005","journal-title":"J. Women\u2019s Health"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"0863","DOI":"10.1371\/journal.pmed.0050132","article-title":"Coverage of cervical cancer screening in 57 countries: Low average levels and large inequalities","volume":"5","author":"Gakidou","year":"2008","journal-title":"PLoS Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1007\/BF03405681","article-title":"Self-collected HPV testing improves participation in cervical cancer screening: A systematic review and meta-analysis","volume":"104","author":"Withrow","year":"2013","journal-title":"Can. J. Public Health"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Duke, P., Godwin, M., Ratnam, S., Dawson, L., Fontaine, D., Lear, A., Traverso-Yepez, M., Graham, W.J., Ravalia, M., and Mugford, G. (2015). Effect of vaginal self-sampling on cervical cancer screening rates: A community-based study in Newfoundland. BMC Womens Health, 15.","DOI":"10.1186\/s12905-015-0206-1"},{"key":"ref_31","unstructured":"World Health Organization (2019). WHO Consolidated Guideline on Self-Care Interventions for Health: Sexual and Reproductive Health and Rights, WHO. Available online: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/325480\/9789241550550-eng.pdf?ua=1."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Camara, H., Zhang, Y., Lafferty, L., Vallely, A.J., Guy, R., and Kelly-Hanku, A. (2021). Self-collection for HPV-based cervical screening: A qualitative evidence meta-synthesis. BMC Public Health, 21.","DOI":"10.1186\/s12889-021-11554-6"},{"key":"ref_33","unstructured":"Conner, M., and Norman, P. (2021). Reference Module in Neuroscience and Biobehavioral Psychology. Health Behavior, Elsevier. [2nd ed.]."}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/29\/6\/308\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:19:06Z","timestamp":1760138346000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/29\/6\/308"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,26]]},"references-count":33,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["curroncol29060308"],"URL":"https:\/\/doi.org\/10.3390\/curroncol29060308","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,26]]}}}