Preventing cervical cancer using HPV self-sampling: direct mailing of test-kits increases screening participation more than timely opt-in procedures - a randomized controlled trial

BMC Cancer

Jan Blaakær¹  Hans Svanholm²  Berit Andersen²  Mette Tranberg²  Bodil Hammer Bech³  Jørgen Skov Jensen⁴ 

[1] Department of Obstetrics and Gynecology, Odense University Hospital;Department of Public Health Programmes, Randers Regional Hospital;Department of Public Health, Section for Epidemiology, Aarhus University;Statens Serum Institut;

关键词: Self-sampling;    Cervical cancer screening;    Cancer prevention;    Screening participation;    Human papillomavirus testing;   

DOI  :  10.1186/s12885-018-4165-4

来源: DOAJ

【 摘 要 】

Abstract Background Cervical cancer screening participation remains insufficient in most countries. Our aim was to evaluate whether offering a HPV self-sampling kit, either mailed directly to the woman’s home or using timely opt-in procedures for ordering the kit, increased screening participation compared with a standard second reminder. Methods In this randomized, controlled effectiveness trial, 9791 Danish women aged 30–64 who were due to receive the second reminder were equally randomized to either: 1) direct mailing of a second reminder and a self-sampling kit (directly mailed group); 2) mailing of a second reminder that offered a self-sampling kit to be ordered by e-mail, text message, phone, or webpage (opt-in group); or 3) mailing of a second reminder to attend regular cytology screening (control group). In an intention-to-treat analysis, we estimated the participation rate at 180 days post intervention, by returning a self-sample or attending regular cytology screening. We calculated the proportion of women with a positive HPV self-sample who attended for cervical cytology triage at the general practitioner within 90 days. Results Participation was significantly higher in the directly mailed group (38.0%) and in the opt-in group (30.9%) than in the control group (25.2%) (participation difference (PD): 12.8%, 95% CI: 10.6–15.0% and PD: 5.7%, 95% CI: 3.5–7.9%, respectively). Within 90 days, 107 women (90.7%, 95% CI: 83.9–95.3%) with a HPV-positive self-sample attended follow-up. Conclusions Offering the opportunity of HPV self-sampling as an alternative to regular cytology screening increased participation; the direct mailing strategy was the most effective invitation strategy. A high compliance with follow-up was seen. Trial registration Current Controlled Trials NCT02680262. Registered 10 February 2016.

【 授权许可】

Unknown