• Kimon Chatzistamatiou, Thomas Vrekoussis, Athena Tsertanidou, Theodoros Moysiadis, Evangelia Mouchtaropoulou, Konstantinos Pasentsis, Anastasia Kitsou, Viktoria Moschaki, Maria Ntoula, Paraskevi Zempili, Despina Halatsi, Theoni Truva, Vaia Piha, Georgia Agelena, Alexandros Daponte, Polyxeni Vanakara, Minas Paschopoulos, Theodoros Stefos, Vasilis Lymberis, Emmanuel N Kontomanolis, Antonis Makrigiannakis, Efthimios Deligeoroglou, Theodoros Panoskaltsis, George Adonakis, George Michail, Kostas Stamatopoulos, and Theodoros Agorastos.
• 1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece.
• J Womens Health (Larchmt). 2020 Nov 1; 29 (11): 1447-1456.

Abstract Background: Human papillomavirus (HPV)-DNA testing combined with self-sampling could increase cervical cancer screening effectiveness, utilizing a sensitive screening modality and an easy sampling method with minimal pain or discomfort. Self-sampling acceptability, though, is pivotal. Materials and Methods: This study is a nested cross-sectional survey within GRECOSELF, a cross-sectional study on HPV-based screening with self-sampling, aiming at investigating self-sampling acceptability among Greek women residing in rural areas, and the factors affecting it. Women between 25 and 60 years old were recruited by midwives participating in a nationwide midwifery network. Participants, after self-sampling, filled out a questionnaire with three sections, one regarding demographic characteristics, a second with questions pertaining to the participants' cervical cancer screening history, and a third with questions regarding the self-sampling process per se. Results: The sample included 13,111 women. Most participants (67.9%), including those screened or not in the past, would prefer self-sampling if assured that the results are not inferior to standard testing. Discomfort or pain during self-sampling was absent or minimal in 97.1% and 96.5% of the cases, respectively, and 74.4% of the women felt adequately confident that they followed the instructions correctly. Women mostly preferred self-sampling at home compared with health care facilities. Pain and discomfort during the procedure, although rare, were significant factors against acceptance. Most of the women reporting a negative impression had a negative experience with conventional sampling in the past. Conclusion: Self-sampling is highly acceptable. Acceptance can be further improved with proper communication of the process and its noninferiority compared with conventional screening.

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