Non-speculum sampling approaches for cervical screening in older women: randomised controlled trial
| Autor: | Anita Wey Wey Lim, Thomas Round, Tony Hollingworth, Rebecca Landy, Jo Waller, Jane Rigney, Peter Sasieni, Laura A.V. Marlow |
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| Rok vydání: | 2021 |
| Předmět: |
general practice
Cervical cancer medicine.medical_specialty Cervical screening Cervical intraepithelial neoplasia business.industry Research Outcome measures Attendance self-sampling medicine.disease early detection of cancer law.invention Randomized controlled trial law Usual care East london Physical therapy Medicine older women Sampling (medicine) human papillomavirus DNA tests Family Practice business |
| Zdroj: | The British Journal of General Practice |
| ISSN: | 1478-5242 0960-1643 |
| DOI: | 10.3399/bjgp.2021.0350 |
| Popis: | BackgroundCervical cancer disproportionately affects women ≥65 years, especially those not screened regularly. Speculum use is a key barrier.AimTo assess if offering non-speculum clinician-taken sampling and self-sampling increases uptake for lapsed attenders aged 50–64 years.Design and settingPragmatic randomised control trial conducted at 10 general practices in East London, UK.MethodParticipants were 784 women aged 50–64 years, last screened 6–15 years before randomisation. Intervention participants received a letter offering the choice of non-speculum clinician- or self-sampling. Control participants received usual care. The main outcome measure was uptake within 4 months.ResultsScreening uptake 4 months after randomisation was significantly higher in the intervention arm: 20.4% (n = 80/393) versus 4.9% in the control arm (n = 19/391, absolute difference 15.5%, 95% confidence interval [CI] = 11.0% to 20.0%, Pn = 120/393) versus control 13.6% (n = 53/391) (absolute difference 17.0%, 95% CI = 11.3% to 22.7%, Pn = 50/393) and control 13.6% (n = 53/391) arms. Ethnic differences were seen in screening modality preference. More White women opted for self-sampling (50.7%, n = 38/75), whereas most Asian and Black women and those from other ethnic backgrounds opted for conventional screening.ConclusionOffering non-speculum clinician-taken sampling and self-sampling substantially increases uptake in older lapsed attendee women. Non-speculum clinician sampling appeals to women who dislike the speculum but still prefer a clinician to take their sample. Providing a choice of screening modality may be important for optimising cervical screening uptake. |
| Databáze: | OpenAIRE |
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