AI Article Synopsis
- HPV self-sampling kits can significantly improve cervical cancer screening rates among women who are usually under-screened compared to traditional methods where a healthcare professional takes samples.
- A systematic review of 33 randomised controlled trials showed that all self-sampling invitation methods were more effective at increasing participation than standard invitations, with the highest participation from community outreach efforts.
- Opt-in invitation strategies were found to be less effective than universal mailings, suggesting that sending kits to all eligible women may lead to better screening outcomes.
Article Abstract
Background: Human papillomavirus (HPV) testing on self-samples represents a great opportunity to increase cervical cancer screening uptake among under-screened women.
Methods: A systematic review and meta-analysis on randomised controlled trials (RCTs) were performed to update the evidence on the efficacy of strategies for offering self-sampling kits for HPV testing compared to conventional invitations and to compare different self-sampling invitation scenarios. Four experimental invitational scenarios were considered. Women in the control group were invited for screening according to existing practice: collection of a cervical specimen by a healthcare professional. Random-effects models were used to pool proportions, relative participation rates and absolute participation differences.
Results: Thirty-three trials were included. In the intention-to-treat analysis, all self-sampling invitation scenarios were more effective in reaching under-screened women compared to controls. Pooled participation difference (PD) and 95% confidence interval (CI) for experimental vs. control was 13.2% (95% CI = 11.0-15.3%) for mail-to-all, 4.4% (95% CI = 1.2-7.6%) for opt-in, 39.1% (95% CI = 8.4-69.9%) for community mobilisation & outreach and 28.1% (23.5-32.7%) for offer at healthcare service. PD for the comparison opt-in vs. mail-to-all, assessed in nine trials, was -8.2% (95% CI = -10.8 to -5.7%).
Discussion: Overall, screening participation was higher among women invited for self-sampling compared to control, regardless of the invitation strategy used. Opt-in strategies were less effective than send-to-all strategies.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9977737 | PMC |
| http://dx.doi.org/10.1038/s41416-022-02094-w | DOI Listing |
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