Knowledge and Attitudes of Bangkok Metropolitan Women towards HPV and Self-Sampled HPV Testing

  • Kittisiam, Thannaporn (Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University) ;
  • Tangjitgamol, Siriwan (Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University) ;
  • Chaowawanit, Woraphot (Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University) ;
  • Khunnarong, Jakkapan (Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University) ;
  • Srijaipracharoen, Sunamchok (Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University) ;
  • Thavaramara, Thaowalai (Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University) ;
  • Pataradool, Kamol (Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University)
  • 발행 : 2016.05.01


Background: To evaluate knowledge of Bangkok women regarding HPV and self-sampled HPV testing, and their attitudes towards testing. Materials and Methods: Thai women who had lived in Bangkok for more than 5 years, aged 25-to-65 years old, were invited to join the study. Participating women were asked to a complete self-questionnaire (Thai language), with literate assistance as needed. The questionnaire was divided into 3 parts: (I) demographic data, (II) knowledge and (III) attitudes towards self-sampled HPV testing. Before proceeding to Part III of the questionnaire, a 15-minute educational video of self-sampled HPV testing was presented to all participants. Results: Among 2,810 women who answered the questionnaires, 33.7% reported that they did not know about HPV. The characteristic features of these women were older age (> 50 years), lower income (< 600 USD/month), unemployed status, and non-attendees at cervical cancer screening. Only small numbers of women (4.6%) responded that they had heard about self-sampled HPV testing. After having information, 59.6% would not use the self-sampled HPV testing as a method of cervical cancer screening (non-acceptance). Factors significantly associated with the non-acceptance were older age, lower income, having no knowledge about HPV or self-collected HPV testing, a perception that the testing was unreliable and a concern that they might not be able to perform it correctly. Conclusions: Nearly half and almost all Bangkok women did not know about HPV and self-sampled HPV testing, respectively. Approximately 60% of Bangkok women refused to do the self-sampled HPV testing. Significant negative attitudes were concerns that the testing would be unreliable and a lack of confidence to perform the procedure correctly. Education about HPV and self-sampled HPV testing, ease of the procedure, or the testing models may increase rate of acceptability or positive attitudes.


연구 과제 주관 기관 : Faculty of Medicine Vajira Hospital


  1. Arbyn M, Verdoodt F, Snijders PJ, et al (2014). Accuracy of human papillomavirus testing on self-collected versus clinician-collected samples: a meta-analysis. Lancet Oncol, 15, 172-83.
  2. Bernstein A, Vitner S, Webber JM (1985). Evaluation of a new tampon device for cytologic autocollection and mass screening of cervical cancer and its precursors. Am J Obstet Gynecol, 151, 351-5.
  3. Bidus MA, Zahn CM, Maxwell GL, et al (2005). The role of self-collection devices for cytology and human papillomavirus DNA testing in cervical cancer screening. Clin Obstet Gynecol, 48, 127-32.
  4. Budge M, Halford J, Haran M, Mein J, Wright G (2005). Comparison of a self-administered tampon ThinPrep test with conventional pap smears for cervical cytology. Aust N Z J Obstet Gynaecol, 45, 215-9.
  5. Budkaew J, Chumworathayi B (2014). Factors associated with decisions to attend cervical cancer screening among women aged 30-60 years in Chatapadung contracting medical unit, Thailand. Asian Pac J Cancer Prev, 15, 4903-7.
  6. Castell S, Krause G, Schmitt M, et al (2014). Feasibility and acceptance of cervicovaginal self-sampling within the German National Cohort (Pretest 2). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz, 57, 1270-6.
  7. Chaowawanit W, Tangjitgamol S, Kantathavorn N, et al (2016). Knowledge, attitudes and behavior of Bangkok metropolitan women regarding cervical cancer screening. Asian Pac J Cancer Prev, 17, 945-52.
  8. Chen SL, Hsieh PC, Chou CH, Tzeng YL (2014). Determinants of women's likelihood of vaginal self-sampling for human papillomavirus to screen for cervical cancer in Taiwan: a cross-sectional study. BMC Womens Health, 14, 139.
  9. Chumworathayi B, Yuenyao P, Luanratanakorn S, et al (2007). Can an appointment-letter intervention increase pap smear screening in Samliem, Khon Kaen, Thailand? Asian Pac J Cancer Prev, 8, 353-6.
  10. Everett T, Bryant A, Griffin MF, et al (2011). Interventions targeted at women to encourage the uptake of cervical screening. Cochrane Database Syst Rev, 5, 2834.
  11. Fargnoli, V., Petignat, P., & Burton-Jeangros, C. (2015). To what extent will women accept HPV self-sampling for cervical cancer screening? A qualitative study conducted in Switzerland. Int J Womens Health, 7, 883-8.
  12. Gakidou E, Nordhagen S, Obermeyer Z (2008). Coverage of cervical cancer screening in 57 countries: low average levels and large inequalities. PLoS Med, 5, 132.
  13. Huh WK, Ault KA, Chelmow D, et al (2015). Use of primary high-risk human papillomavirus testing for cervical cancer screening: interim clinical guidance. Gynecol Oncol, 136, 178-82.
  14. Khuhaprema T, Attasara P, Srivatanakul P, et al (2012). Organization and evolution of organized cervical cytology screening in Thailand. Int J Gynaecol Obstet, 118, 107-11.
  15. Kritpetcharat O, Suwanrungruang K, Sriamporn, S, et al(2003). The coverage of cervical cancer screening in Khon Kaen, northeast Thailand. Asian Pac J Cancer Prev, 4, 103-105.
  16. Lee B, Cho HY, Jeon KJ, et al (2016). Detection of high-risk human papillomavirus using menstrual blood in women with high-grade squamous intraepithelial lesions or high-risk human papillomavirus infections: A pilot study. J Obstet Gynaecol Res, 42, 319-24.
  17. Lee HY, Koopmeiners JS, Rhee TG, Raveis VH, Ahluwalia JS (2014). Mobile phone text messaging intervention for cervical cancer screening: changes in knowledge and behavior pre-post intervention. J Med Internet Res, 16, 196.
  18. Oranratanaphan S, Termrungruanglert W, Khemapech N (2014). Acceptability of self-sampling HPV testing among Thai women for cervical cancer screening. Asian Pac J Cancer Prev, 15, 7437-41.
  19. Othman NH, Mohamad Zaki FH (2014). Self-collection tools for routine cervical cancer screening: a review. Asian Pac J Cancer Prev, 15, 8563-9.
  20. Penaranda E, Molokwu J, Flores S, et al (2015). Women's attitudes toward cervicovaginal self-sampling for high-risk HPV Infection on the US-mexico border. J Low Genit Tract Dis, 19, 323-8.
  21. Pengsaa P, Sriamporn S, Kritpetcharat O, et al (2003). A comparison of cytology with Pap smears taken by a gynecologist and with a self-sampling device. Asian Pac J Cancer Prev, 4, 99-102.
  22. Quincy BL, Turbow DJ, Dabinett LN (2012). Acceptability of self-collected human papillomavirus specimens as a primary screen for cervical cancer. J Obstet Gynaecol, 32, 87-91.
  23. Sahasrabuddhe VV, Gravitt PE, Dunn ST, et al (2014). Comparison of human papillomavirus detections in urine, vulvar, and cervical samples from women attending a colposcopy clinic. J Clin Microbiol, 52, 187-192.
  24. Scarinci IC, Litton AG, Garces-Palacio IC., et al (2013). Acceptability and usability of self-collected sampling for HPV testing among African-American women living in the Mississippi Delta. Womens Health Issues, 23, 123-30.
  25. Sriplung H, Singkham P, Iamsirithaworn S, Jiraphongsa C, Bilheem S (2014). Success of a cervical cancer screening program: trends in incidence in songkhla, southern Thailand, 1989-2010, and prediction of future incidences to 2030. Asian Pac J Cancer Prev, 15, 10003-8.
  26. Sultana F, Mullins R, Murphy M, et al (2015). Women's views on human papillomavirus self-sampling: focus groups to assess acceptability, invitation letters and a test kit in the Australian setting. Sex Health, 12, 279-86.
  27. Szarewski A, Cadman L, Mesher D, et al (2011). HPV self-sampling as an alternative strategy in non-attenders for cervical screening - a randomised controlled trial. Br J Cancer, 104, 915-20.
  28. Thanapprapasr D, Deesamer S, Sujintawong S, Udomsubpayakul U, Wilailak S (2012). Cervical cancer screening behaviours among Thai women: results from a cross-sectional survey of 2112 healthcare providers at Ramathibodi Hospital, Thailand. Eur J Cancer Care (Engl), 21, 542-7.
  29. Torre, L. A., Bray, F., Siegel, R. L., Ferlay, J., Lortet-Tieulent, J., & Jemal, A. (2015). Global cancer statistics, 2012. CA Cancer J Clin, 65, 87-108.
  30. Virtanen, A., Anttila, A., & Nieminen, P. (2015). The costs of offering HPV-testing on self-taken samples to non-attendees of cervical screening in Finland. BMC Womens Health, 15, 99.
  31. WHO (2013). Guidelines for screening and treatment of precancerous lesions for cervical cancer prevention. Geneva.
  32. Wongwatcharanukul L, Promthet S, Bradshaw P, Jirapornkul C, Tungsrithong N (2014). Factors affecting cervical cancer screening uptake by Hmong hilltribe women in Thailand. Asian Pac J Cancer Prev, 15, 3753-3756.