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Primary Study on Providing a Basic System for Uterine Cervical Screening in a Developing Country: Analysis of Acceptability of Self-sampling in Lao PDR

  • Yoshida, Tomomi (Department of Laboratory Sciences, Graduate School of Health Sciences, Gunma University) ;
  • Nishijima, Yoshimi (Department of Laboratory Sciences, Graduate School of Health Sciences, Gunma University) ;
  • Hando, Kiyomi (The Non-Government Organization, International Support and Partnership for Health (ISAPH)) ;
  • Vilayvong, Soulideth (Department of Pathology, Faculty of Medicine, University of Health Sciences Lao PDR) ;
  • Arounlangsy, Petsamone (Department of Pathology, Faculty of Medicine, University of Health Sciences Lao PDR) ;
  • Fukuda, Toshio (Department of Laboratory Sciences, Graduate School of Health Sciences, Gunma University)
  • Published : 2013.05.30

Abstract

Background: Most developing countries have been unable to implement well-organized health care systems, especially comprehensive Pap smear screening-based programs. One of the reasons for this is regional differences in medical services, and a low-cost portable cervical screening system is necessary. To improve regional discrepancies in cervical screening systems, we investigated the usefulness and acceptability of cervical selfsampling by liquid-based cytology (LBC) for 290 volunteers in the Lao PDR. Materials and Methods: Following health education with comprehensive documents, cervical self-sampling kits by LBC were distributed in three provincial, district, and village areas to a total of 290 volunteers, who were asked to take cytology samples by themselves. Subsequently, the acceptability of self-sampling was evaluated using a questionnaire. Results: The documents were well understood in all three regions. Regarding the acceptability of self-sampling, the selections for subsequent screening were 62% self-sampling, 36% gynecologist-sampling, 1% either method, and 1% other methods. The acceptability rates were higher in the district and the village than in the province. For the relationship between acceptability and pregnancy, the self-sampling selection rate was higher in the pregnancy-experienced group (75%) than in the pregnancy-inexperienced group (60%). For the relationship between selection of self-sampling and experience of screening, the self-sampling selection rate was higher in the screening-inexperienced group (62%) than in the screening-experienced group (52%). Conclusions: Our data show that this new way forward, involving a combination of self-sampling and LBC, is highly acceptable regardless of age, educational background, and residence in rural areas in a developing country.

Keywords

Cervical cytology;self-sampling;acceptability;regional difference;developing country

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