The effect of self-sampled HPV testing on participation to cervical cancer screening in Italy: a randomised controlled trial (ISRCTN96071600)
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BACKGROUND: In Italy, cervical cancer screening programmes actively invite women aged 25-64 years. Programmes are hindered by low participation. METHODS: A sample of non-responder women aged 35-64 years, belonging to three different programmes (in Rome, Florence and Teramo), was randomly split into four arms: two control groups received standard recall letters to perform either Pap-test (first group) or human papillomavirus (HPV) test (second group) at the clinic. A third arm was sent letters offering a self-sampler for HPV testing, to be requested by phone, whereas a fourth group was directly sent the self-samplers home. RESULTS: Compliance with standard recall was 13.9% (N619). Offering HPV test at the clinic had a nonsignificant effect on compliance (N616, relative risk (RR)=1.08; 95% CI=0.82-1.41). Self-sampler at request had the poorest performance, 8.7% (N622, RR=0.62; 95% CI=0.45-0.86), whereas direct mailing of the self-sampler registered the highest compliance: 19.6% (N616, RR=1.41; 95% CI=1.10-1.82). This effect on compliance was observed only in urban areas, Florence and Rome (N438, RR=1.69; 95% CI=1.24-2.30), but not in Abruzzo (N178, RR=0.95; 95% CI=0.61-1.50), a prevalently rural area. CONCLUSIONS: Mailing self-samplers to non-responders may increase compliance as compared with delivering standard recall letters. Nevertheless, effectiveness is context specific and the strategy costs should be carefully considered.
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Participation was not significantly different when hrHPV testing was performed versus when cytology was performed in two Italian studies (P=0.60 v P=0.76).
“The participation was not significantly different when hrHPV testing was performed versus when cytology was performed (P=0.60 v P=0.76).104 117”
From Detecting cervical precancer and reaching underscreened women by using HPV testing on self samples: updated meta-analyses (2018) · cites this paper as [104]
The Results (‘Effect on compliance’; page unavailable) report similar participation after invitations for clinic-based HPV testing (14.9%) and standard Pap-test recall (13.9%). The Abstract (‘Results’; page unavailable) explicitly calls the difference nonsignificant. Our copy does not report the cited P=0.60 or P=0.76 values; this paper also accounts for only one of the two studies cited. (LLM, conf=0.83)
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- Authors
- the Self-Sampling Study Working Group, Giorgi Rossi, P., Marsili, L. M., Camilloni, L., Iossa, A., Lattanzi, A., Sani, C., Di Pierro, C., Grazzini, G., Angeloni, C., Capparucci, P., Pellegrini, A., Schiboni, M. L., Sperati, A., Confortini, M., Bellanova, C., D'Addetta, A., Mania, E., Visioli, C. B., Sereno, E., & Carozzi, F.
- Affiliations
- Regione Lazio (IT)
- ASL Roma (IT)
- Istituto per lo Studio e la Prevenzione Oncologica (IT)
- Azienda Ospedaliera San Giovanni Addolorata (IT)
- ORCID
- Venue
- British Journal of Cancer
- Published
- 2010-12-21
- Volume
- 104
- Issue
- 2
- Pages
- 248-254
- ISSN
- 0007-0920 (ISSN-L)
- 1532-1827
- PMC
- PMC3031894
- OpenAlex
- W2054969461
- Cited by
- 125
- References
- 42
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 3 · 2023: 9 · 2022: 8 · 2021: 4 · 2020: 6 · 2019: 7 · 2018: 9 · 2017: 9 · 2016: 8 · 2015: 14 · 2014: 18 · 2013: 11 · 2012: 6
- FWCI
- 4.90
- 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)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Ministero della Salute
- 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, HPV self-sampling, screening uptake, non-responders, Pap smear, urban-rural differences, Italy
- MeSH terms
- Adult, Uterine Cervical Neoplasms, Female, Humans, Italy, Mass Screening, Middle Aged, Patient Acceptance of Health Care, Patient Compliance, Surveys and Questionnaires, Vaginal Smears, Alphapapillomavirus
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