Vaginal self-sampling is a cost-effective way to increase participation in a cervical cancer screening programme: a randomised trial
Open accessAbstract
BACKGROUND: Cervical cancer screening coverage remains insufficient in most countries. Our objective was to assess whether in-home vaginal self-sampling with a dry swab for high-risk human papillomavirus (HR-HPV) testing is effective and cost-effective in increasing participation in cervical cancer screening. METHODS: In March 2012, 6000 unscreened women aged 30-65 years, living in a French region covered by a screening programme, who had not responded to an initial invitation to have a Pap smear were equally randomised to three groups: 'no intervention'; 'recall', women received a letter to have a Pap smear; and 'self-sampling', women received a self-sampling kit to return to a centralised virology laboratory for PCR-based HPV testing. RESULTS: Participation was higher in the 'self-sampling' than in the 'no intervention' group (22.5% vs 9.9%, P<0.0001; OR 2.64) and 'recall' group (11.7%, P<0.0001; OR 2.20). In the 'self-sampling' group, 320 used the self-sampling kit; for 44 of these women with positive HR-HPV test results, 40 had the recommended triage Pap smear. The ICER per extra screened woman was 77.8[euro ] and 63.2[euro ] for the 'recall' and 'self-sampling' groups, respectively, relative to the 'no intervention' group. CONCLUSIONS: Offering an in-home, return-mail kit for vaginal self-sampling with a dry swab is more effective and cost-effective than a recall letter in increasing participation in cervical cancer screening.
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Three (12%) of the 25 trials met the criteria for low risk of bias in all categories.
“Three (12%) of the 25 trials met the criteria for low risk of bias in all categories.114 115 117”
From Detecting cervical precancer and reaching underscreened women by using HPV testing on self samples: updated meta-analyses (2018) · cites this paper as [115]
The Materials and Methods > Design section describes this paper as a single three-group randomised trial, not an assessment of 25 trials. Searches for “25 trials” and “low risk of bias” found no passage in our copy reporting that three trials (12%) met low-risk criteria in all categories. Page numbers were not available in the indexed passages. (LLM, conf=0.77)
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- Authors
- Haguenoer, K., Sengchanh, S., Gaudy-Graffin, C., Boyard, J., Fontenay, R., Marret, H., Goudeau, A., Pigneaux de Laroche, N., Rusch, E., & Giraudeau, B.
- Affiliations
- Inserm (FR)
- Centre Hospitalier Universitaire de Tours (FR)
- Université de Tours (FR)
- Corresponding author
- Haguenoer, K
- Venue
- British Journal of Cancer
- Published
- 2014-09-23
- Volume
- 111
- Issue
- 11
- Pages
- 2187-2196
- ISSN
- 0007-0920 (ISSN-L)
- 1532-1827
- PMC
- PMC4260034
- OpenAlex
- W2071793902
- Cited by
- 106
- References
- 41
- Citations by year
- 2026: 5 · 2025: 13 · 2024: 12 · 2023: 8 · 2022: 13 · 2021: 4 · 2020: 10 · 2019: 10 · 2018: 9 · 2017: 7 · 2016: 5 · 2015: 9 · 2014: 1
- FWCI
- 5.56
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-sa
- www.springer.com/tdm (unspecified)
- Locations
- British Journal of Cancer (publishedVersion, cc-by-nc-sa)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- HAL (submittedVersion, cc-by-nc-sa)
- Funders
- Institut National Du Cancer
- National Cancer Institute
- Topics
- Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- cervical cancer screening, vaginal self-sampling, high-risk human papillomavirus testing, screening uptake, cost-effectiveness, Pap smear, HPV triage
- MeSH terms
- Adult, Aged, Uterine Cervical Neoplasms, Cost-Benefit Analysis, Female, Follow-Up Studies, Humans, Middle Aged, Patient Participation, Reagent Kits, Diagnostic, Vaginal Smears, Early Detection of Cancer
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