Ethnographic study of the barriers and facilitators to implementing human papillomavirus (HPV) self-sampling as a primary screening strategy for cervical cancer among Inuit women of Nunavik, Northern Quebec

ABSTRACT

The rate of cervical cancer among Canadian Inuit women is higher than the national average. To date, early detection remains the best strategy for reducing the incidence of cervical cancer and its consequences. Thus, the aim of this study was to explore the barriers and facilitators in implementing human papillomavirus (HPV) self-sampling as a primary screening strategy for cervical cancer among Inuit women of Nunavik in Northern Quebec. A focused ethnographic approach was adopted. Inuit women of Nunavik participated in individual or group interviews during which a semi-structured interview guide was used to determine their perceptions of the barriers and facilitators to implementing HPV self-sampling as a primary screening strategy for cervical cancer. The data were analysed based on Paillé’s grounded theory of qualitative analysis. Twenty-eight Inuit women participated in this study. Analysis revealed five subcategories of facilitators and four barriers. Inuit women may embrace the self-sampling method. Importantly, in order to be effective, these strategies must be culturally sensitive and adapted to women’s preferences so as to increase sustainability. The results of this study provide the means for integrating the perspectives of Inuit women in implementing HPV self-sampling as a primary screening strategy for cervical cancer in Nunavik. Consideration of these facilitators and barriers might maximise the chance of success and optimise the screening participation rate.

KEYWORDS:

• Human papillomavirus (HPV)
• self-sampling
• cervical cancer screening
• Inuit women
• ethnography

Acknowledgments

We would like to thank the participating community members, as well as the urban center staff and patients for their generous collaboration and genuine interest in this project. Special thank you to Christina Santella for reviewing the manuscript for consistency.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Compliance with ethical standards

The project was approved by the Research Ethics Board at the Université du Québec à Trois-Rivières (CER-18-248-07.27) and McGill University Institutional research board (A06-E46-18B).

Additional information

Funding

This work received funding from the Ministère de l’Éducation et de l’Enseignement Supérieur du Québec (MÉES), and from the Canadian Institutes of Health Research (CIHR).