May 12, 2023 — Mailing sample kits for cervical cancer screening doubled the screening rate in a cohort of low-income and screening women, researchers say.
Self-sampling kits, which detect human papilloma virus (HPV), are only available for use in clinical trials, but the researchers are hopeful that these kits will eventually be approved for use by the general public.
Researchers, from the University of North Carolina, discovered the use of these kits in the My Body, My Test-3 study, which was published online Thursday in the Journal The Lancet Public Health.
Experts write in a comment published with the study said it “provides needed evidence that … self-collected samples can be an effective strategy for hard-to-reach populations”.
The study included 665 women (ages 25-64) in North Carolina who were uninsured or enrolled in Medicaid or Medicare. The patients had low-income backgrounds and lived in urban areas. More than half self-reported as black or Hispanic (55%), uninsured (78%) or unemployed (57%). None of them 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 sent an HPV self-collection kit and assisted in scheduling an in-person examination. The kit included the Viba-Brush device, which is inserted into the vagina like a tampon to collect the sample.
The other third of the women, the control group, only received help with scheduling.
The team found that mailing self-achievement tests along with helping women book appointments at the clinic improved screening rates twice as compared to just helping patients make an appointment.
The screening success rate among those given the collection kit at home was 72%, compared to 37% in the control group.
Of those who got the combos, 78% returned them. This is “impressive,” the comment’s authors say, as previous studies have reported rates of return of only between 8% and 20%.
About 23% of eligible women are at least a year late for cervical cancer screening, According to the National Cancer Institute. Jennifer Smith, PhD, MPH, professor of epidemiology at the University of North Caroline Chapel Hill Gillings School of Global Public Health and study author, believes that every woman deserves equal access to cervical screening.
“I think we really need to make efforts to increase cervical cancer screening among women who are a year or more behind in screening than the recommended guidelines,” Smith said. “Together with the extensive evidence both in the United States and globally, we have demonstrated that a self-achievement intervention works well and can motivate screening acceptance by breaking down barriers for populations with less access to care.”
“We hope that this research combined with all of the comprehensive evidence of positive performance of HPV self-collection will provide additional information for consideration by the FDA for approval of the kits for initial screening,” said Smith.
“Government approval of at-home HPV tests will have a huge impact,” said co-author Noel Brewer, PhD, also of the University of North Carolina Chapel Hill. “We can better reach those who live in rural areas where cervical cancer is difficult to screen for.”
