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J Med Screen. 2015 Mar;22(1):28-37. doi: 10.1177/0969141314558785. Epub 2014 Nov 17.

A randomized controlled trial in non-responders from Newcastle upon Tyne invited to return a self-sample for Human Papillomavirus testing versus repeat invitation for cervical screening.

Author information

1
Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, St. Bartholomew's School of Medicine and Dentistry, London, EC1M 6BQ.
2
Department of Pharmacy, Health and Wellbeing, Faculty of Applied Sciences, Sciences Complex, City Campus, Chester Road, University of Sunderland, SR1 3SD scott.wilkes@sunderland.ac.uk.
3
Newcastle Hospitals, Community Health, New Croft Centre, Market Street (East), Newcastle upon Tyne, NE1 6ND.

Abstract

BACKGROUND:

Non-attenders for cervical screening are at increased risk of cervical cancer. Studies offering self-sampling for high-risk Human Papillomavirus (HrHPV) testing have shown greater uptake than sending another invitation for cytology.

OBJECTIVES:

To explore whether uptake would increase in a less diverse, more stable population than the previous English study, which demonstrated a lower response rate than other studies. The primary objective was whether non-attenders were more likely to respond to a postal invitation, including kit, to collect a self-sample compared with a further invitation for cytology screening. The secondary objective was whether women with an abnormal result would attend for follow-up.

METHODS:

6000 non-attenders for screening in this pragmatic, randomized (1:1) controlled trial in Newcastle-upon-Tyne were sent an HPV self-sample kit (intervention) or a further invitation for cytology screening (comparator).

RESULTS:

411(13%) responded to the intervention, returning a self-sample (247(8%)) or attending for cytology (164(5%)), compared with 183(6%) attending for cytology, relative risk 2.25 (95% CI 1.90-2.65) (comparator arm). Of those testing hrHPV positive (32(13%)), 19(59%) subsequently attended cytology screening. Of those in the intervention group who attended for cytology screening without returning an hrHPV self-sample (n = 164), 5% (n = 8) were referred for colposcopy - all attended. In the comparator group eight of the nine referred for colposcopy attended.

CONCLUSION:

Persistent non-responders to invitations for cervical screening are significantly more likely to respond to a postal invitation to return a self-collected sample for HPV testing than a further invitation for cytology screening. However, just over half followed up on this positive HPV result.

KEYWORDS:

cervical screening; human papillomavirus; non-attenders; self-sampling

PMID:
25403717
DOI:
10.1177/0969141314558785
[Indexed for MEDLINE]

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