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Int J Cancer. 2018 Aug 15;143(4):861-868. doi: 10.1002/ijc.31391. Epub 2018 Apr 10.

A randomized, controlled trial of two strategies of offering the home-based HPV self-sampling test to non- participants in the Flemish cervical cancer screening program.

Author information

1
Centre for Cancer Detection, Flanders, Belgium.
2
University Hospital Leuven, Campus St. Rafael, Leuven, Belgium.
3
AML, Sonic Healthcare, Antwerp, Belgium.
4
National Reference Centre for HPV, Brussels, Belgium.
5
AMBIOR, Laboratory for Cell Biology & Histology, University of Antwerp, Antwerp, Belgium.
6
International Centre for Reproductive Health, Ghent University, Ghent, Belgium.
7
Belgian Cancer Registry, Saint-Josse-ten-Noode, Belgium.

Abstract

We conducted a randomized, controlled trial to evaluate different strategies of offering an HPV-self sampling program, and compared this with two control groups. All total of 35,354 women who did not participate in the Flemish cancer screening program were included in the study: 9,118 received a HPV self-collection brush (RIATOL qPCR HPV genotyping test (qPCR [E6/E7]); 9,098 were offered the opportunity to order an HPV-selfsampling brush, 8,830 received the recall letter; 8,849 received no intervention. Within 12 months after the mailing, 18.7% of the women who had received the brush, participated by returning a self-sample sample, while 10.6% women allocated to the opt- in group did so. 10.5% women who received the standard recall letter, had a PAP smear taken within a period of 12 months; while 8% women did so without receiving an intervention at all. Participation in postmenopausal women was higher than in women younger than 50 in both self-sampling arms. Screening by means of the self-sample kit increased by age, contradictory when screening is performed by a PAP smear. Of those testing hrHPV positive (9.5%), 88.9% attended for follow up cytology. The mean DNA concentration, found in the self-sampler, decreased by age, causing a higher number of inconclusive results. Our results support the efficacy of a self-sampling strategy to increase participation in the Flemish screening program. Self-sampling seems particularly acceptable to postmenopausal non-responders. Future research should focus on the performance of different self-sampling devices in post-menopausal women as low DNA concentrations exponentially increased over age.

KEYWORDS:

Flemish cervical cancer screening program; human papilloma virus; non-responders; self-sampling

PMID:
29569715
DOI:
10.1002/ijc.31391
[Indexed for MEDLINE]
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