Reaching women who do not participate in the regular cervical cancer screening programme by offering self-sampling kits: A systematic review and meta-analysis of randomised trials
Abstract
Introduction Population coverage for cervical cancer screening is an important determinant explaining differences in the incidence of cervical cancer between countries. Offering devices for self-sampling has the potential to increase participation of hard-to-reach women. Methods A systematic review and meta-analysis were performed to evaluate the participation after an invitation including a self-sampling device (self-sampling arm) versus an invitation to have a sample taken by a health professional (control arm), sent to under-screened women. Results Sixteen randomised studies were found eligible. In an intention-to-treat analysis, the pooled participation in the self-sampling arm was 23.6% (95% confidence interval (CI)=20.2-27.3%), when self-sampling kits were sent by mail to all women, versus 10.3% (95% CI=6.2-15.2%) in the control arm (participation difference: 12.6% [95% CI=9.3-15.9]). When women had to opt-in to receive the self-sampling device, as used in three studies, the pooled participation was not higher in the self-sampling compared to the control arm (participation difference: 0.2% [95% CI=-4.5-4.9%]). Conclusion An increased participation was observed in the self-sampling arm compared to the control arm, if self-sampling kits were sent directly to women at their home address. However, the size of the effect varied substantially among studies. Since participation was similar in both arms when women had to opt-in, future studies are warranted to discern opt-in sc…
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Two previous participation meta-analyses showed that sending self sampling kits to a woman's home address generated greater response rates than invitation or reminder letters.
“Two previous participation meta-analyses showed that sending self sampling kits to a woman’s home address generated greater response rates than invitation or reminder letters.23 24”
From Detecting cervical precancer and reaching underscreened women by using HPV testing on self samples: updated meta-analyses (2018) · cites this paper as [23]
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Arbyn, M., Smith, S. B., Temin, S., Sultana, F., & Castle, P. (2018) · BMJ · doi:10.1136/bmj.k4823 · Cited by 851 · see citing works
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- Authors
- Verdoodt, F., Jentschke, M., Hillemanns, P., Racey, C. S., Snijders, P. J. F., & Arbyn, M.
- Affiliations
- Institut Scientifique de Santé Publique (BE)
- Medizinische Hochschule Hannover (DE)
- University of Toronto (CA)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Corresponding author
- Arbyn, M.
- Venue
- European Journal of Cancer
- Publisher
- Elsevier BV
- Published
- 2015-11
- Volume
- 51
- Issue
- 16
- Pages
- 2375-2385
- ISSN
- 0959-8049 (ISSN-L)
- OpenAlex
- W2161243824
- Cited by
- 275
- References
- 10
- Citations by year
- 2026: 19 · 2025: 18 · 2024: 23 · 2023: 23 · 2022: 29 · 2021: 23 · 2020: 22 · 2019: 26 · 2018: 43 · 2017: 27 · 2016: 20 · 2015: 2
- FWCI
- 4.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Cancer (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- cervical cancer screening, screening uptake, home-based screening, underscreened women
- MeSH terms
- Uterine Cervical Neoplasms, Female, Health Services Accessibility, Humans, Patient Participation, Postal Service, Predictive Value of Tests, Self Care, Vaginal Smears, Early Detection of Cancer, Intention to Treat Analysis
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