945 Performance of HPV self-sampling for cervical cancer screening in urban, semi urban, rural, tribal and difficult to reach women in India

Introduction/Background Cervical cancer is the second most common cancer among Indian women. Issues like unavailability of screening services, lack of awareness and discomfort associated with vaginal speculum examination makes screening unattractive. HPV self-sampling appears to overcome these challenges. In the present paper we present our data of three trials on HPV self-sampling, undertaken among diverse populations, aiming to investigate the attitudes, acceptability, barriers, predictors, validity and experiences with regards to HPV self-sampling among Indian women. Methodology These are community-based studies conducted among urban slum (500), urban non-slum (500), semi-urban (227), rural (600) and tribal (120 women) using HPV self-sampling for cervical cancer screening. Health awareness was delivered using different modalities like pamphlets, health education programme in groups, movie clips/videos etc. The tribal cluster also enrolled 120 male partners for awareness and semi-urban cluster also used point of care HPV test in addition to Hybrid capture. The studies involved, door to door visit to enlist the eligibles, obtaining informed consents, conducting personal interviews, distribution and collection of self-samplers and focus group discussions. Women with positive result on either tests, were offered further work up at the Nodal Hospital. Results The acceptance rate of self-sampling was 99.2%, 97%, 98.8% and 95.8% and HPV positivity was 7%, 7.8%, 7.8% and 8.7% in urban slum, urban non-slum, rural and tribal women. Overall, agreement rate between health personnel collected samples and self-collected samples was 95%. The major barriers of self-sampling were lack of confidence about performing the self-test correctly, fear that test would be painful, illiteracy and anxiety about test results. There was significant improvement in knowledge and attitudes about cervical cancer and screening. Conclusion HPV self-sampling has good acceptability among Indian women and this evidence can be used to advance public health policies to scale-up screening across rural India and other low middle income countries. Disclosures NIL.