Women's preference for HPV self-sampling devices: a programme-embedded, large-scale paired comparative study within the cervical cancer screening programme in the Capital Region of Denmark.

Abstract

To demonstrate women's preferences for three human papillomavirus (HPV) self-sampling devices. Cross-sectional, programme-embedded paired comparative study with randomised sampling order within device pairs. Organised cervical cancer screening programme in the Capital Region of Denmark. 1760 women eligible for cervical cancer screening (April 2024 to May 2025), assigned to one of three groups: (1) Evalyn versus FLOQSwab (n=518), (2) Evalyn versus SensiGrip (n=657) and (3) FLOQSwab versus SensiGrip (n=585). Primary: device preference. Secondary: sampling-experience (self-reported). Data were assessed with χ² tests for preference, logistic regression for predictor analysis and Wilcoxon signed-rank equivalence test with two one-sided test procedures to assess sampling experience. Overall, 95.7% rated HPV self-sampling a positive experience and 87.3% preferred HPV self-sampling in future screening. SensiGrip was preferred significantly over FLOQSwab (p<0.001), with participants rating ease of use and sampling certainty higher for SensiGrip. No significant differences in preference were observed between Evalyn and either alternative device in the primary analysis (p>0.05) although Evalyn scored higher in sampling certainty. Sampling order influenced preference in Evalyn comparisons. Prior experience with self-sampling, screening history and subcohort membership did not significantly influence device preference. Overall, participants rated self-sampling a positive experience. SensiGrip was preferred over FLOQSwab, while Evalyn demonstrated comparable overall acceptability to both alternative devices in the primary implementation-focused analysis. These findings suggest that device replacement would be acceptable from a screening participation perspective, particularly a shift from FLOQSwab to SensiGrip.