A Mail-Based HPV Self-Collection Program to Increase Cervical Cancer Screening in Appalachia: Results of a Group Randomized Trial.

Autor:	Reiter PL; The Ohio State University, Columbus, OH, United States., Shoben AB; The Ohio State University, Columbus, OH, United States., Cooper S; The Ohio State University, Columbus, OH, United States., Ashcraft AM; West Virginia University, United States., McKim Mitchell E; University of Virginia, Charlottesville, VA, United States., Dignan M; University of Kentucky, Lexington, KY, United States., Cromo M; University of Kentucky, Lexington, KY, United States., Walunis J; The Ohio State University, United States., Flinner D; The Ohio State University, United States., Boatman D; West Virginia University, United States., Hauser L; University of Virginia, United States., Ruffin MT; Penn State Milton S. Hershey Medical Center, Hershey, PA, United States., Belinson JL; Cleveland Clinic, United States., Anderson RT; University of Virginia, Charlottesville, VA, United States., Kennedy-Rea S; West Virginia University, United States., Paskett ED; The Ohio State University, Columbus, OH, United States., Katz ML; The Ohio State University, Columbus, OH, United States.
Jazyk:	angličtina
Zdroj:	Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology [Cancer Epidemiol Biomarkers Prev] 2024 Oct 24. Date of Electronic Publication: 2024 Oct 24.
DOI:	10.1158/1055-9965.EPI-24-0999
Abstrakt:	Background: Despite the promise of mail-based human papillomavirus (HPV) self-collection programs for increasing cervical cancer screening, few have been evaluated in the United States. We report the results of a mail-based HPV self-collection program for underscreened women living in Appalachia. Methods: We conducted a group randomized trial during 2021-2022 in the Appalachian regions of Kentucky, Ohio, Virginia, and West Virgnia. Participants were women ages 30-64 who were underscreened for cervical cancer and from a participating health system. Participants in the intervention group (n=464) were mailed an HPV self-collection kit followed by telephone-based patient navigation (if needed), and participants in the usual care group (n=338) were mailed a reminder letter to get a clinic-based cervical cancer screening test. Generalized linear mixed models compared cervical cancer screening between study groups. Results: Overall, 14.9% of participants in the intervention group and 5.0% of participants in the usual care group were screened for cervical cancer. The mail-based HPV self-collection intervention increased cervical cancer screening compared to the usual care group (OR=3.30, 95% CI: 1.90-5.72, p=0.005). One or more high-risk HPV types were detected in 10.5% of the returned HPV self-collection kits. Among participants in the intervention group who patient navigators attempted to contact, 44.2% were successfully reached. Conclusions: HPV self-collection increased cervical cancer screening, and future efforts are needed to determine how to optimize such programs, including the delivery of patient navigation services. Impact: Mail-based HPV self-collection programs are a viable strategy for increasing cervical cancer screening among underscreened women living in Appalachia.
Databáze:	MEDLINE
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