May 12, 2023 — Mailing do-it-yourself sampling kits to screen for cervical cancer doubled the detection rate in a population of low-income, underscreened women, researchers say.
Self-sampling kits, which detect human papillomavirus (HPV), are available only for use in clinical trials, but the researchers hope that these kits will eventually be approved for use by the general public.
The researchers, from the University of North Carolina, explored the use of these kits in the My Body, My Test-3 study, which was posted online Thursday in the newspaper Lancet Public Health.
Experts writing on a comment published with the study said it “provides the required evidence that … self-collected samples may be an effective strategy for hard-to-reach populations.”
The study involved 665 women (ages 25 to 64) in North Carolina who were uninsured or enrolled in Medicaid or Medicare. The patients had a low-income background and lived in urban areas. More than half self-reported as Black or Hispanic (55%), uninsured (78%), or unemployed (57%). None had had a Pap smear in at least 4 years or a high-risk HPV test in the past 6 years.
Two-thirds of the women were mailed an HPV self-collection kit and received help scheduling an in-person testing appointment. The kit included a Viba-Brush device, which is inserted into the vagina like a tampon to collect the sample.
The other third of women, the control group, only received help with programming.
The team found that mailing self-collected tests along with helping women make clinic appointments improved detection rates by twofold compared with just helping patients make an appointment.
Detection success among those who received the home collection kit was 72% compared to 37% in the control group.
Of those who received the kits, 78% returned them. This is “impressive,” the comment authors say, as previous studies have reported return rates of only 8%-20%.
About 23% of eligible women are at least one year behind in cervical cancer screening, according to the National Cancer Institute. Jennifer Smith, PhD, MPH, a professor of epidemiology at the University of North Carolina Chapel Hill Gillings School of Global Public Health and an author of the study, believes that all women deserve equal access to cervical screening.
“I think we really need to make efforts to increase cervical cancer screening among women who have fallen a year or more behind recommended guidelines,” Smith said. “We have shown alongside extensive evidence both in the US and globally that the self-collection intervention works well and can drive uptake of screening by breaking down barriers for populations that have less access to care.”
“We hope that this research, in combination with all of the extensive evidence on the positive performance of HPV self-harvest, will provide additional information for FDA consideration for kit approval for primary screening,” Smith said.
“Government approval of home HPV testing would have a huge impact,” said co-author Noel Brewer, PhD, also of UNC Chapel Hill. “We could better reach people in rural areas where cervical cancer screening is difficult.”
—————————————————-
Source link