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Showing content from https://pubmed.ncbi.nlm.nih.gov/23867008/ below:

Comparison of use of vaginal HPV self-sampling and offering flexible appointments as strategies to reach long-term non-attending women in organized cervical screening

Randomized Controlled Trial

doi: 10.1016/j.jcv.2013.06.029. Epub 2013 Jul 15. Comparison of use of vaginal HPV self-sampling and offering flexible appointments as strategies to reach long-term non-attending women in organized cervical screening

Affiliations

Affiliation

¹ Department of Obstetrics and Gynaecology, Skane University Hospital, Lund University, Lund, Sweden. Lotten.Darlin@med.lu.se

PMID: 23867008
DOI: 10.1016/j.jcv.2013.06.029

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Randomized Controlled Trial

Comparison of use of vaginal HPV self-sampling and offering flexible appointments as strategies to reach long-term non-attending women in organized cervical screening

Lotten Darlin et al. J Clin Virol. 2013 Sep.

doi: 10.1016/j.jcv.2013.06.029. Epub 2013 Jul 15. Affiliation

¹ Department of Obstetrics and Gynaecology, Skane University Hospital, Lund University, Lund, Sweden. Lotten.Darlin@med.lu.se

PMID: 23867008
DOI: 10.1016/j.jcv.2013.06.029

Item in Clipboard

Abstract

Background: Many cervical cancers occur among women who have not attended cervical screening. Strategies to reach non-attending women may improve the effectiveness of cervical screening programmes.

Objective: To compare the responses among long-term non-attending women to either (i) HPV-testing of a self-collected vaginal sample, or (ii) cytological screening with a flexible no-fee appointment for sampling at an outpatient clinic.

Study design: Among the 242,000 women aged 32-65 years in Southern Sweden, we identified 28,635 women who had not had any cervical smears taken for >9 years. We randomized 1000 women to invitation to HPV self-sampling, and 500 women to flexible outpatient clinic appointments. Responding women received a questionnaire about their reasons for previous non-attendance.

Results: The response rate to HPV self-sampling was three times higher than the flexible outpatient clinic invitations (147/1000 women (14.7%) compared to 21/500 (4.2%) p<0.0001). High-risk (hr)-HPV was found in 10/147 self-sampled women (6.9%). 7/10 hr-HPV-positive women attended colposcopy, but no HSIL was found. Among the clinic-sampled women, 2/21 had hr-HPV and 1/21 had HSIL. Reasons for not attending were "uncomfortable with vaginal examination", "feel healthy", "lack of time" and "experience of unfriendly health workers".

Conclusions: Although the response rate was low for both interventions, the invitation to vaginal HPV self-sampling was more effective for increasing the coverage of the screening programme. The fact that "uncomfortable with vaginal examination" was the most common reason for non-attending suggests that self-sampling could be further explored as a strategy to increase the coverage of cervical screening programmes.

Keywords: Cytology; HPV testing; Non-attendance; Screening; Self-collected vaginal smear; Vaginal smear.

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