ArticleBMJ open2017
Self-administered versus provider-directed sampling in the Anishinaabek Cervical Cancer Screening Study (ACCSS): a qualitative investigation with Canadian First Nations women.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Does self-sampling for human papilloma virus testing have the potential to increase cervical cancer screening? An updated meta-analysis of observational studies and randomized clinical trials.Frontiers in public health · 2022Pooled it
- Working towards a comprehensive understanding of HPV and cervical cancer among Indigenous women: a qualitative systematic review.BMJ open · 2021Pooled it
- HPV self-sampling for cervical cancer screening: a systematic review of values and preferences.BMJ global health · 2021Pooled it
- Trial
- Who is left out? A systematic review on the barriers and facilitators for screening participation reported by people in vulnerable situations with strategies for the future.Public health in practice (Oxford, England) · 2026Review
- Implementing HPV self-collection: a scoping review of facilitators and strategies among Indigenous women and people with a cervix.BMC public health · 2026Article
- Article
- Article
- Practitioners support and intention to adopt universal access to self-collection in Australia's National Cervical Screening Program.Cancer medicine · 2024Article
- Awareness of human papillomavirus infection among Indigenous males in North America and Oceania: a Scoping Review.Cancer causes & control : CCC · 2024Article
- Older women's perceptions of HPV self-sampling and HPV-sampling performed by a midwife - a phenomenographic study.BMC public health · 2024Article
- Are Canadian Women Prepared for the Transition to Primary HPV Testing in Cervical Screening? A National Survey of Knowledge, Attitudes, and Beliefs.Current oncology (Toronto, Ont.) · 2023Article
- Intervention to Increase Cervical Cancer Screening Behavior among Medically Underserved Women: Effectiveness of 3R Communication Model.Healthcare (Basel, Switzerland) · 2023Article
- Understanding the Challenges of HPV-Based Cervical Screening: Development and Validation of HPV Testing and Self-Sampling Attitudes and Beliefs Scales.Current oncology (Toronto, Ont.) · 2023Article
- Women's acceptability of a self-collect HPV same-day screen-and-treat program in a high burden setting in the Pacific.BMC health services research · 2022Article
- Results of Self-Sampling Methodology Impression for Cervical Cancer Screening in Mongolia.Asian Pacific journal of cancer prevention : APJCP · 2022Article
- HPV Self-Sampling for Cervical Cancer Screening among Women Living with HIV in Low- and Middle-Income Countries: What Do We Know and What Can Be Done?Healthcare (Basel, Switzerland) · 2022Review
- Toward equitable access to oncology care for Indigenous Peoples in Canada: Implications for nursing.Canadian oncology nursing journal = Revue canadienne de nursing oncologique · 2022Article
- Article
- Feasibility of Utilizing Social Media to Promote HPV Self-Collected Sampling among Medically Underserved Women in a Rural Southern City in the United States (U.S.).International journal of environmental research and public health · 2021Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhile (Pap)anicolaou screening has helped to decrease cervical cancer incidence in Canada, First Nations women continue to have a higher burden and mortality relative to mainstream populations. Many First Nations women may feel uncomfortable with the invasiveness of this test, contributing to this statistic. Implemented from 2009 to 2015 in 10 Northwest Ontario First Nations communities, the Anishinaabek Cervical Cancer Screening Study (ACCSS) uniquely addressed this Indigenous health inequity through a mixed methods approach.
objectiveOur goal was to offer an alternative test which the women could do themselves: human papillomavirus (HPV) testing based on self-sampling. We investigated whether First Nations women preferred HPV self-sampling over healthcare provider (HCP)-administered Pap screening.
methodsParticipatory action researchinformed by the ethical space concept has guided all stages of the ACCSS. We conducted qualitative interviews with 16 HCPs and 8 focus group discussions with 69 female community members followed by a cluster-randomised controlled trial (RCT). Here, we draw on the qualitative field data and an end-of-study community update gathering to disseminate and contextualise research findings. Informant data were evaluated using thematic analysis.
resultsWe discuss factors influencing participants' strong preference for HPV self-sampling over physician-conducted Pap screening. Key arguments included enhanced accessibility and more personal control, less physical and emotional discomfort and fewer concerns regarding privacy of test results. For future implementation of HPV self-sampling, study participants emphasised the need for more culturally sensitive education addressed to community members of all genders, starting at school, clarifying that HPV causes cervical cancer. Further, HPV infection should be de-stigmatised by accentuating that it affects men and women alike.
conclusionHere we show that self-sampling in conjunction with community engagement and culturally sensitive education and could be a viable option for underscreened Canadian First Nations women. These informant data echo our previous RCT results.
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