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

Abstract

<b>Background:</b> 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 differencesin medical services, and a low-cost portable cervical screening system is necessary. To improve regionaldiscrepancies in cervical screening systems, we investigated the usefulness and acceptability of cervical selfsamplingby liquid-based cytology (LBC) for 290 volunteers in the Lao PDR. Materials and <br/><b>Methods</b>: Followinghealth education with comprehensive documents, cervical self-sampling kits by LBC were distributed in threeprovincial, district, and village areas to a total of 290 volunteers, who were asked to take cytology samplesby themselves. Subsequently, the acceptability of self-sampling was evaluated using a questionnaire. <br/><b>Results</b>:The documents were well understood in all three regions. Regarding the acceptability of self-sampling, theselections 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 thepregnancy-experienced group (75%) than in the pregnancy-inexperienced group (60%). For the relationshipbetween selection of self-sampling and experience of screening, the self-sampling selection rate was higher inthe screening-inexperienced group (62%) than in the screening-experienced group (52%). <br/><b>Conclusions</b>: Ourdata show that this new way forward, involving a combination of self-sampling and LBC, is highly acceptableregardless of age, educational background, and residence in rural areas in a developing country.