Dr. Eric Chamot, associate professor in the department of epidemiology at the University of Alabama at Birmingham—working in conjunction with department colleague Dr. Sadeep Shrestha, associate professor, along with UAB alumnus gynecologic oncologist Dr. Groesbeck P. Parham — recently assessed the conditions under which women from the southern African country of Zambia with a history of cervical cancer screening by visual inspection with acetic acid might switch to human papillomavirus-based testing in the future.
Dr. Chamot and his fellow researchers conducted a choice-based conjoint survey in a sample of 238 women recently screened by visual inspection in Lusaka, the capital of and largest city in Zambia. The screening attributes considered in hypothetical-choice scenarios included screening modality, sex, and age of the examiner, whether screening results would be presented visually, distance from home to the clinic, and wait time for results.
Of female participants in the study, 208 (87.4 percent) provided responses sufficiently reliable for analysis. Laboratory testing on urine samples was the preferred screening modality, followed by visual screening, laboratory testing on self-collected vaginal specimens, and laboratory testing on nurse-collected cervical specimens. However, market simulation suggested that only 39.7 percent of the respondents would prefer urine testing offered by a female nurse in her 30s over visual inspection of the cervix conducted by a male nurse in his 20s if extra wait time were as short as one hour and the option to view their cervix were not available.
Study results suggest that, for some women, the level of preference for human papillomavirus-based screening strategies may depend highly on the process and conditions of service delivery.
“Preference for Human Papillomavirus-Based Cervical Cancer Screening: Results of a Choice-Based Conjoint Study in Zambia” was published in October in the Journal of Lower Genital Tract Disease.