May 12, 2023 — Sending do-it-yourself sampling kits to test for cervical cancer doubled the number of screenings in a population of low-income and underscreened women, researchers say.
Self-sampling kits, which detect human papillomavirus (HPV), are only available for use in clinical trials, but researchers hope these kits will eventually be approved for use by the general public.
Researchers from the University of North Carolina examined the use of these kits in the My Body, My Test-3 study, which was published online in Thursday’s news Lancet Public Health.
experts write in a vaccine Published alongside the study said it “provides requisite evidence that … self-collected samples may be an effective strategy for hard-to-reach populations.”
The study included 665 women (aged 25-64) in North Carolina who were either uninsured or enrolled in Medicaid or Medicare. Patients had low-income backgrounds and lived in urban areas. More than half described themselves as black or Hispanic (55%), uninsured (78%) or unemployed (57%). None had a Pap smear in the past 4 years or a high-risk HPV test in the past 6 years.
Two-thirds of the women were sent an HPV self-sampling kit and helped to schedule an in-person screening appointment. The kit included a Veeba-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 planning assistance.
The team found that helping women book clinic appointments as well as sending self-sample tests doubled the screening rate compared to helping patients schedule appointments.
Screening success was 72% among those who received home collection kits, compared to 37% in the control group.
Of those who received kits, 78% returned them. The authors of the commentary say this is “impressive”, as previous studies have reported recurrence rates as low as 8%–20%.
About 23% of eligible women reach out for cervical cancer screening late by at least one year. 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 every woman deserves equal access to cervical screening.
“I think we need to make a real effort to increase cervical cancer screening among women who are overdue for screening a year or more beyond the recommended guidelines,” Smith said. “We have proven with extensive evidence in the US and globally that self-collection interventions work well and can motivate participation in screening by breaking down barriers for populations with less care.”
“We hope that this study, taken together with all the broader evidence on the positive performance of HPV self-collection, will provide additional information that will be considered by the FDA for approval of primary screening kits,” Smith said.
“Government approval of home HPV testing would have a huge impact,” said study co-author Noel Brewer, PhD, of UNC Chapel Hill. “We can better reach people in rural areas where cervical cancer screening is difficult.”
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