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J Glob Oncol. 2017 Jan 18;3(5):444-454. doi: 10.1200/JGO.2016.005629. eCollection 2017 Oct.

Acceptability of Human Papillomavirus Self-Sampling for Cervical Cancer Screening in an Indigenous Community in Guatemala.

Author information

, , and , University of Michigan, Ann Arbor, MI; and , Institute of Nutrition of Central America and Panama; , Universidad Mariano Galvez de Guatemala; , Universidad Rafael Landivar, Guatemala City, Guatemala; and , The Hebrew University, Jerusalem, Israel.



Cervical cancer rates in Latin America are higher than those in developed countries, likely because of the lower prevalence of screening. Specifically, less than 40% of women in Guatemala are regularly screened and even fewer women are screened in indigenous communities. Current screening strategies-Pap smears and visual inspection with acetic acid-might not be the most effective methods for controlling cancer in these settings. We thus investigated the potential of self-collection of cervical samples with testing for human papillomavirus (HPV) to help prevent cervical cancer in an indigenous community in Guatemala.

Patients and Methods:

A community representative random sample of 202 indigenous women age 18 to 60 years residing in Santiago Atitlan, Guatemala, were surveyed to assess knowledge of and risk factors for HPV and cervical cancer. Women were then invited to self-collect a cervical sample using HerSwab collection kits to assess the prevalence of HPV and the acceptability of self-sampling.


Of 202 women who completed the survey, 178 (89%) provided a self-sample. In all, 79% of these women found the test comfortable, 91% found the test easy to use, and 100% reported they were willing to perform the test periodically as a screening method. Thirty-one samples (17%) were positive for at least one of 13 high-risk HPV types, and eight (4.5%) were positive for HPV 16/18.


HPV testing by using self-collected samples was well accepted, suggesting that it is a plausible modality for cervical cancer screening in indigenous communities. Further studies are needed to assess rates of follow-up after a positive test and to determine whether these findings extend to other indigenous and nonindigenous communities in Guatemala and Latin America.

Conflict of interest statement

The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to or Anna GottschlichNo relationship to discloseAlvaro Rivera-AndradeNo relationship to discloseEdwin GrajedaNo relationship to discloseChristian AlvarezNo relationship to discloseCarlos Mendoza MontanoNo relationship to discloseRafael MezaNo relationship to disclose

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