hpv screening kit puts women in control: researcher
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"at-home kits can better reach people without access to screening, who are embarrassed by a cervical exam or whose religious beliefs include modesty,” said study co-author noel t. brewer.
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a new study has found that mailing human papillomavirus (hpv) self-collection kits to under-screened women almost doubled the rate of participation in the program.
the study, published in lancet public health, found that women who were mailed an hpv test and offered scheduling assistance in booking an in-clinic appointment were significantly more likely to get themselves checked out than those who were offered scheduling assistance but not a home kit.
the majority of sexually active people will be infected by hpv
“my hope going into this study was that mailing kits for home-based collection might increase cervical cancer screening, but we were thrilled to find a nearly two-fold increase in screening uptake,” said jennifer s. smith, corresponding author of the study and professor of epidemiology at unc’s gillings school of public health. “many hadn’t engaged in the screening system for a while and getting the kit to their homes helped break down a fundamental barrier.”
the vast majority of sexually active people will be infected by hpv at some point in their lives, making it the most common sexually transmitted infection in canada and the world, according to a special report by the canadian cancer society. hpv-related cancers of the mouth and throat are on the rise in the country, with nearly 4,400 people diagnosed in 2016 and about 1,200 losing their lives every year.
while most infections go away on their own in a couple of years without the host experiencing any physical symptoms, there are more than 100 types of hpv and around 25 of these are believed to present a cancer risk.
the study recruited 665 women between the ages of 25 and 64 from 22 counties in north carolina. these participants, who were uninsured and enrolled in medicaid or medicare, had not had received a pap test in the past four years and were overdue for a screening.
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two-thirds of the women were sent at-home hpv collection kits and then given assistance in making a screening appointment at a clinic. the remaining third did not receive a kit but were given the same scheduling assistance. the primary outcome of the study was either attending an in-clinic screening or testing hpv-negative through a self-collected sample within six months of enrolling in the study.
at-home kits reach people whose religious beliefs make screening appointments uncomfortable
researchers found that 72 per cent of women who received an hpv kit participated in the screening program compared to 37 per cent of the women who did not. among those who received a kit, screening uptake did not vary by age, race/ethnicity, medicaid coverage, education or time since last screening.
“home screening for cervical cancer puts women in control,” said noel t. brewer, co-author of the study, gillings distinguished professor in public health and unc lineberger member. “most can avoid having to go to a doctor’s appointment. these at-home kits can better reach people without access to screening, who are embarrassed by a cervical exam or whose religious beliefs include modesty.”
according to smith, the home kits are ideal for low-income, under-screened women who might not otherwise get themselves checked out. “we’re now working with clinical partners to identify women who might be overdue for screening through electronic medical records,” she said.
“we hope to provide the option of either mailing them a self-collection kit to use at-home to mail back to us or hand a kit directly to them when they come into clinics for other services with the vision to eventually make self-collection a regular clinical provision.”
dave yasvinski is a writer with healthing.ca
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