Crossover study shows urine-based screening improves acceptability in HPV-positive women, suggesting a feasible alternative to cervical sampling.
INTRODUCTION: Despite available Pap tests, less than 5% of eligible Ghanaian women are screened for human papillomavirus (HPV) due to cost, infrastructure, and discomfort. To address these barriers to cervical cancer screening, we designed a noninvasive, urine-based HPV screening device specifically for low-resource settings. This study aimed to assess the feasibility and acceptability of the device among patients after use. METHODS: We conducted a crossover study of known HPV-positive women at the largest referral hospital in Ghana from January to June 2025. First, participants provided a urine sample using the HPV screening device, followed by the collection of a cervical sample by a health care professional. Likert-scale questions were administered after each screening method to assess feasibility and acceptability using the validated “Satisfaction with Decision,” “Device Usability Questionnaire,” “System Usability Scale,” and “Device Preference Questionnaire” quantitative scales. Wilcoxon signed-rank and one-sample binomial tests were performed to analyze responses with Stata SE18. RESULTS: A total of 100 participants completed enrollment. Participants rated urine-based collection with the device significantly higher than gold standard, cervical sampling across the following criteria: alignment with personal values ( P <.001), ease of use ( P <.001), comfort ( P <.001), perceived safety ( P <.001), willingness to recommend ( P =.0018), and desired method for future use ( P <.001). Ninety-four participants (93.1%) preferred HPV screening with the urine-based device over cervical sampling. CONCLUSIONS/IMPLICATIONS: Participants strongly preferred urine-based over cervical-based HPV screening. This device has the potential to increase access to HPV screening in low-resource settings.
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Frankowitz et al. (2026) studied this question.
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