A randomized controlled trial in non-responders from Newcastle upon Tyne invited to return a self-sample for Human Papillomavirus testing versus repeat invitation for cervical screening
| Autor: | Anne Szarewski, Rob Edwards, Michelle Kleeman, Janet Austin, Lesley Ashdown-Barr, Louise Cadman, Diana Mansour, Scott Wilkes |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
medicine.medical_specialty Uterine Cervical Neoplasms Alphapapillomavirus Specimen Handling law.invention Randomized controlled trial law Internal medicine medicine Humans Mass Screening Human papillomavirus Aged Vaginal Smears sub_healthsciences Gynecology Cervical cancer Cervical screening top_sciences business.industry Health Policy Papillomavirus Infections Public Health Environmental and Occupational Health Middle Aged Uterine Cervical Dysplasia medicine.disease Non responders Increased risk England Newcastle upon tyne Patient Compliance Female business Self sampling |
| Zdroj: | Journal of Medical Screening. 22:28-37 |
| ISSN: | 1475-5793 0969-1413 |
| DOI: | 10.1177/0969141314558785 |
| Popis: | Background Non-attenders for cervical screening are at increased risk of cervical cancer. Studies offering self-sampling for high-risk Human Papillomavirus (HrHPV) testing have shown greater uptake than sending another invitation for cytology. Objectives To explore whether uptake would increase in a less diverse, more stable population than the previous English study, which demonstrated a lower response rate than other studies. The primary objective was whether non-attenders were more likely to respond to a postal invitation, including kit, to collect a self-sample compared with a further invitation for cytology screening. The secondary objective was whether women with an abnormal result would attend for follow-up. Methods 6000 non-attenders for screening in this pragmatic, randomized (1:1) controlled trial in Newcastle-upon-Tyne were sent an HPV self-sample kit (intervention) or a further invitation for cytology screening (comparator). Results 411(13%) responded to the intervention, returning a self-sample (247(8%)) or attending for cytology (164(5%)), compared with 183(6%) attending for cytology, relative risk 2.25 (95% CI 1.90–2.65) (comparator arm). Of those testing hrHPV positive (32(13%)), 19(59%) subsequently attended cytology screening. Of those in the intervention group who attended for cytology screening without returning an hrHPV self-sample (n = 164), 5% (n = 8) were referred for colposcopy - all attended. In the comparator group eight of the nine referred for colposcopy attended. Conclusion Persistent non-responders to invitations for cervical screening are significantly more likely to respond to a postal invitation to return a self-collected sample for HPV testing than a further invitation for cytology screening. However, just over half followed up on this positive HPV result. |
| Databáze: | OpenAIRE |
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