Knowledge, Practices, and Acceptability of Vulvar Self-Examination in Patients in Colposcopy and Vulvar Dermatology Clinics
Our study investigated current knowledge, practices, and acceptability of vulvar self-examination (VSE) in a population at higher risk for vulvar cancer. Patients presenting to colposcopy and vulvar dermatology clinics at Women's College Hospital, Toronto, Canada were recruited. Participants received a questionnaire adapted from a similar Italian study conducted in 2021. Statistical analysis was completed using descriptive statistics, chi-square test, Fisher exact test, and linear logistic regression. Research ethics board approval was obtained (#2022-0104-E). From October 2022 to July 2023, 264 participants completed the survey (71% response rate), consisting of 46% colposcopy patients and 54% vulvar dermatology patients. The median age of the participants was 49.5 (range 23-87) years, and 87% of participants had attained a bachelor's degree or higher. Overall, 86% of participants had never been taught VSE before. Only 33% of participants could correctly draw and label a simple sketch of the vulva. Most (95%) were interested in learning more about VSE. Patients who had looked at their vulvas at least once before scored better on 7 out of 9 knowledge-based questions and drawing a vulva sketch (P < 0.05). Patients who had been previously taught VSE were more likely to seek medical attention for vulvar abnormalities (P < 0.05). Sociodemographic characteristics including younger age, non-White ethnicity, and lower education were associated with lower scores on knowledge-based questions and/or a vulva sketch (P < 0.05). Knowledge gaps exist in vulvar anatomy among a sample of highly educated patients at higher risk for vulvar cancer. Knowledge was higher among those who had previously engaged in VSE, and there was high interest in learning VSE. Future directions include further teaching and study of VSE practices and attitudes across Canada.