TY - JOUR T1 - Offering HPV self-sampling kits: an updated meta-analysis of the effectiveness of strategies to increase participation in cervical cancer screening JF - British Journal of Cancer Y1 - 2022 A1 - Stefanie Costa A1 - Bo Verberckmoes A1 - Philip E Castle A1 - M. Arbyn KW - cervical cancer screening KW - HPV KW - SCREENING KW - self-sampling KW - self-sampling kits AB -

BACKGROUND:
Human papillomavirus (HPV) testing on self-samples represents a great opportunity to increase cervical cancer screening uptake among under-screened women.

METHODS:
A systematic review and meta-analysis on randomised controlled trials (RCTs) were performed to update the evidence on the efficacy of strategies for offering self-sampling kits for HPV testing compared to conventional invitations and to compare different self-sampling invitation scenarios. Four experimental invitational scenarios were considered. Women in the control group were invited for screening according to existing practice: collection of a cervical specimen by a healthcare professional. Random-effects models were used to pool proportions, relative participation rates and absolute participation differences.

RESULTS:
Thirty-three trials were included. In the intention-to-treat analysis, all self-sampling invitation scenarios were more effective in reaching under-screened women compared to controls. Pooled participation difference (PD) and 95% confidence interval (CI) for experimental vs. control was 13.2% (95% CI = 11.0–15.3%) for mail-to-all, 4.4% (95% CI = 1.2–7.6%) for opt-in, 39.1% (95% CI = 8.4–69.9%) for community mobilisation & outreach and 28.1% (23.5–32.7%) for offer at healthcare service. PD for the comparison opt-in vs. mail-to-all, assessed in nine trials, was −8.2% (95% CI = −10.8 to −5.7%).

DISCUSSION:
Overall, screening participation was higher among women invited for self-sampling compared to control, regardless of the invitation strategy used. Opt-in strategies were less effective than send-to-all strategies.

M3 - 10.1038/s41416-022-02094-w ER -