Abstract 1044: Patient acceptability of human papillomavirus (HPV) self-sampling for cervical cancer screening to reach under-screened women who present to the emergency department
Authors: Sara Heinert, Ronald Ikechi, Eileen Hsieh, Neha Maddali, Rufine Kendra Soh, Yugledys Hoyos, Giana Oelkers, Camille Grullon, Maya Iglesias, Pamela Ohman-Strickland, Jonathan McCoy, Christine Ramdin, Racquel Kelly Kohler
Journal: Cancer Research (2025)

Abstract Despite advancements in cervical cancer screening, treatment, and preventive measures, marked disparities exist among vulnerable populations. While several factors contribute to disparities, over half of cervical cancer cases are diagnosed in women who rarely or never screen. Emergency departments (EDs) tend to serve in a safety net capacity for underserved patients and thus can be an effective site to reach patients overdue for cancer screening. HPV self-sampling, where women use a swab to collect their own cervicovaginal sample, has similar accuracy to clinician-collected samples, has recently been FDA approved, and addresses barriers to screening. However, the optimal kit distribution strategy remains unknown. ED-based in-person distribution with same-day return of self-sampling kits has the potential to alleviate issues of prior trials mailing kits to women’s homes. As a first step to implementing such a program, we surveyed women eligible for cervical cancer screening in two large EDs who presented with non-critical conditions to determine patient acceptability and preferences for HPV self-sampling in the ED. We conducted 118 surveys. Average participant age was 44 years (SD=10), 9% were Asian, 31% were Black, and 35% were Hispanic. Over half (55%) of participants had private insurance, 23% had Medicaid, 18% had no insurance; 28% had no primary care doctor. Fourteen percent of participants were overdue for cervical cancer screening (last Pap was &amp;gt;3 years ago or their Pap/HPV co-test was &amp;gt;5 years ago). Most participants (88% overall, 87% of overdue women) said they were willing to use a HPV self-sampling kit if it was offered acutely in the ED, and 89% overall and 87% of overdue women were confident in their ability to collect their sample correctly. The most prevalent concerns of using the kit were: that the test was not done right (50%) and not knowing how to perform the test (31%). Most women (71% overall, 80% overdue) said they would feel comfortable using the self-sampling kit in an ED bathroom. Of all women not comfortable, the most common reason was that it was a public place/no privacy (27%). When given the choice, 36% of all women would prefer to self-sample in the ED bathroom, 34% would prefer to take the kit home to complete and mail it back, and 30% would prefer collection by a physician or nurse. Preference for collection in an ED bathroom was higher (47%) for overdue women. Our survey showed strong patient acceptability of HPV self-sampling in the ED. Our next step is to conduct a pilot trial implementing HPV self-sampling kit distribution in the ED and navigation to follow-up care to improve cervical cancer screening access. Participants’ most prevalent concern of not performing the test correctly suggests that education and instructions for self-sampling prior to use will be an important component to successful roll-out. Citation Format: Sara Heinert, Ronald Ikechi, Eileen Hsieh, Neha Maddali, Rufine Kendra Soh, Yugledys Hoyos, Giana Oelkers, Camille Grullon, Maya Iglesias, Pamela Ohman-Strickland, Jonathan McCoy, Christine Ramdin, Racquel Kelly Kohler. Patient acceptability of human papillomavirus (HPV) self-sampling for cervical cancer screening to reach under-screened women who present to the emergency department [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 1044.