In the Journals Plus

Study: 78% of women complied with mail-based HPV self-testing program

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December 3, 2018

Almost 80% of women returned HPV self-testing kits in the mail during a pilot study conducted in the Appalachian region of Ohio — an indication that at-home HPV testing can be used to reach underscreened women, researchers reported in Sexually Transmitted Diseases.

“Although HPV self-testing is currently not an approved or recommended screening strategy in the U.S., our study shows that self-testing is a potentially promising strategy in the future for reaching women who have not been recently screened for cervical cancer,” Paul L. Reiter, PhD, MPH, associate professor of health behavior and health promotion at Ohio State University’s College of Public Health, told Infectious Disease News.

According to Reiter and colleagues, prior research has shown that the accuracy of HPV self-testing — which requires women to collect their own cervicovaginal sample — is comparable to provider-collected samples in detecting cervical disease.

For the pilot study of the mail-based program — known as the Health Outcomes through Motivation and Education (HOME) Project — the researchers recruited 103 women from Appalachian Ohio between 2015 and 2016. Reiter and colleagues noted that Appalachian Ohio, which is composed of 32 county regions in southern and eastern Ohio, has higher incidence rates of cervical cancer compared with the rest of the state and country.

Country road in autumn 
Most women in Appalachian Ohio who participated in a pilot study investigating the usefulness of home self-testing for HPV mailed the kits back to researchers.
Source: Adobe Stock

Participants were aged 30 to 65 years and had not received a Pap test in at least 3 years, according to the study. They were randomly assigned to either the control group, in which participants received self-test instructions developed by the device manufacturer and a standard information brochure about cervical cancer, or the intervention group, in which self-test instructions developed by the HOME Project and a photo story information brochure about cervical cancer were included. Both groups received their HPV self-test, instructions and informational brochures in the mail.

Study findings showed that 78% (n = 80) of the women returned their HPV self-test and that return rates were similar between the intervention and control groups, 78% vs. 77% (OR = 1.09; 95% CI, 0.433-2.76).

Tests detected an oncogenic HPV type in 26% of the returned samples, Reiter and colleagues reported. Although the women received recommendations to schedule cervical cancer screening appointments, only 11% of all the study participants received a Pap test during the study period and rates of Pap testing were similar between the intervention group and control groups, 14% vs. 8% (OR = 1.91; 95% CI, 0.52-6.97).

Furthermore, the researchers recorded high levels of satisfaction and positive experiences with the process among the women who returned the self-test. However, Reiter and colleagues underscored the need to study ways to improve optimization of the strategy, including increasing the rate of follow-up appointment.

“An important next step for studies in the U.S. is the implementation of mail-based HPV self-testing programs that are larger than our pilot study and conducted under more ‘real-world’ scenarios, since our program was conducted as a research study,” Reiter said. – by Marley Ghizzone

Disclosures: The authors report no relevant financial disclosures.