Offering self-sampling for human papillomavirus testing to non-attendees of the cervical screening programme: Characteristics of the responders
Abstract Background Self-sampling for high-risk human papillomavirus (hrHPV) testing is accepted by up to 30% of non-attendees to the regular cervical screening programme. Here, the yield of cervical intraepithelial neoplasia (CIN)2 or worse (⩾CIN2) and CIN3 or worse (⩾CIN3) of 15, 274 HPV self-samp...
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Published in | European journal of cancer (1990) Vol. 48; no. 12; pp. 1799 - 1808 |
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Main Authors | , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Kidlington
Elsevier Ltd
01.08.2012
Elsevier |
Subjects | |
Online Access | Get full text |
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Summary: | Abstract Background Self-sampling for high-risk human papillomavirus (hrHPV) testing is accepted by up to 30% of non-attendees to the regular cervical screening programme. Here, the yield of cervical intraepithelial neoplasia (CIN)2 or worse (⩾CIN2) and CIN3 or worse (⩾CIN3) of 15, 274 HPV self-sampling responders amongst non-attendees were compared to that of 176, 027 women participating in regular screening in the same period and in the same region. We also analysed which subpopulations amongst non-attendees are targeted by HPV self-sampling, and which characteristics relate to hrHPV prevalence and yield of ⩾CIN2/⩾CIN3. Method Data from two consecutive self-sampling studies were pooled. ⩾CIN2/⩾CIN3 yields, screening history, age and ethnic status were retrieved from centralised pathology and screening databases, respectively. A logistic regression model was fitted to analyse method of invitation, ethnicity, age group, and screening history as predictors for response rate, hrHPV presence and ⩾CIN2/⩾CIN3 in non-attendees. For screening history analyses, women <34 years were excluded since it was the first screening round in their life. Findings ⩾CIN2/⩾CIN3 yields of HPV self-sampling responders were higher than those of screening participants (⩾CIN2: relative risk (RR) = 1.6, 95% confidence interval = 1.4–1.9; ⩾CIN3: RR = 1.8, 95% CI = 1.5–2.1 with relative risk values increasing with age (test of homogeneity: ⩾CIN2: p = 0.04; ⩾CIN3: p = 0.03). Native Dutch non-attendees responded better than immigrants (32% versus 22%, p < 0·001) and those screened in the previous round revealed a higher response than underscreened (i.e. previous smear taken >7 years ago) or never screened (34% versus 25%, p < 0·001) women. Strikingly, amongst under- and never screened women aged ⩾39 years, never screened women responded better (25% versus 23%, p < 0·001). ⩾CIN2 rates were higher amongst responding native Dutch women than immigrants ( p < 0·01), and higher in under-/never screened women than in women screened in the previous round ( p < 0·01). Interpretation Offering hrHPV self-sampling increases the efficacy of the screening programme by targeting a substantial portion of non-attendees of all ethnic groups who have not regularly been screened and are at highest risk of ⩾CIN2. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Feature-1 |
ISSN: | 0959-8049 1879-0852 |
DOI: | 10.1016/j.ejca.2011.11.022 |