Acceptability of, and preference for, HPV self-sampling for physically disabled women: a cross-sectional survey

Background: Physically Disabled women face multiple barriers to cervical screening, contributing to lower uptake and increased health inequalities. Human papillomavirus (HPV) self-sampling has been shown to increase screening participation in under-screened populations, but little is known about its acceptability for Disabled women.

Methods: A cross-sectional online survey with 1,493 UK-based participants who identified as having a physical disability, impairment, condition, or difference that makes cervical screening difficult or impossible. Participants completed questions on the acceptability of HPV self-sampling, attitudes and beliefs relating to self-sampling, and future screening preferences. Descriptive statistics and multinomial logistic regression were used to analyse responses.

Results: Most participants (63.3%) reported that they would be able to carry out self-sampling themselves and (59.1%) would be willing for a healthcare professional to use a self-sampling kit on their behalf. Many (70.5%) had concerns about not performing the test correctly. Around half (53.0%) would prefer self-sampling at home if offered a screening choice. Women who had never attended screening, or who had delayed/missed appointments, were significantly more likely to prefer self-sampling (odds ratios 13.11 and 5.25, respectively) than women who had always attended. Approximately a fifth of participants (18.7%) would prefer a non-speculum clinician-taken test.

Conclusion: HPV self-sampling was acceptable to many physically Disabled women and preferred over conventional screening, particularly among those who had delayed/missed screening or never attended. Implementation should include tailored accessible instructions to support HPV selfsampling, disability-informed clinical support, and consideration of non-speculum clinician-taken samples to ensure equitable access and reduce inequalities in cervical screening.