07 Nov Mailed HPV Kits Improved Cervical Cancer Screening

MedicalResearch.com Interview with:
Rachel L. Winer, PhD
Professor Department of Epidemiology
School of Public Health HPV Research Group
University of Washington Seattle, WA 

MedicalResearch.com: What is the background for this study?

Response: In the U.S., 25% of women do not receive recommended cervical cancer screening. Increasing screening participation is a high priority, because over half of the 12,000 cervical cancers diagnosed each year in the U.S. are in women who are underscreened.

Currently available options for cervical cancer screening in the U.S. include Pap testing or HPV testing, either alone or in combination. HPV self-sampling is an emerging option for screening because HPV tests – unlike Pap tests – can be performed on either clinician- or self-collected samples, with similar accuracy. Internationally, several countries (including Australia and the Netherlands) include HPV self-sampling as a cervical cancer screening option for underscreened women. 

 MedicalResearch.com: What are the main findings?

Response: In order to evaluate the impact of mailed HPV kits in a real-world U.S. health system setting, we identified nearly 20,000 women aged 30-64 years at Kaiser Permanente Washington who hadn’t been screened for cervical cancer in more than three years, and randomized them into two groups. The first group received unsolicited mailed HPV self-sampling kits that they could complete as an alternative to Pap screening, and the second group received only usual care reminders for in-clinic screening.

We found that mailing HPV self-sampling kits to underscreened women increased cervical cancer screening participation by 50% compared to usual care reminders for Pap screening. Most women (88%) who used the HPV self-sampling kit tested negative, signaling low risk for cervical cancer. The remaining 12% were identified to be at increased risk for cervical cancer, yet only 70% of those women received appropriate in-clinic follow-up.

MedicalResearch.com: What should readers take away from your report?

 Response: Mailing home-based HPV screening kits is a feasible and effective strategy for encouraging hard-to-reach women within a U.S. health system to get screened for cervical cancer. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Future research and implementation efforts should focus on ways to further encourage use of mailed HPV kits and in-clinic follow-up for positive results in order to maximize detection and treatment of pre-cancers in hard-to-reach women.

Any disclosures? The trial was funded by the National Cancer Institute (R01 CA168598).

Citation:

Winer RL, Lin J, Tiro JA, et al. Effect of Mailed Human Papillomavirus Test Kits vs Usual Care Reminders on Cervical Cancer Screening Uptake, Precancer Detection, and Treatment: A Randomized Clinical Trial. JAMA Netw Open. 2019;2(11):e1914729. doi:https://doi.org/10.1001/jamanetworkopen.2019.14729

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Last Updated on November 7, 2019 by Marie Benz MD FAAD