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Cited by 92Cervical Cancer and HPV ResearchWomen's cancer prevention and managementGlobal Cancer Incidence and Screening

Preventing cervical cancer using HPV self-sampling: direct mailing of test-kits increases screening participation more than timely opt-in procedures - a randomized controlled trial

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Tranberg, Mette, Bech, Bodil Hammer, Blaakær, Jan, Jensen, Jørgen Skov, Svanholm, Hans, Andersen, Berit·2018·BMC Cancer
DOI 10.1186/s12885-018-4165-4PMC PMC5845195
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Abstract

BACKGROUND: Cervical cancer screening participation remains insufficient in most countries. Our aim was to evaluate whether offering a HPV self-sampling kit, either mailed directly to the woman's home or using timely opt-in procedures for ordering the kit, increased screening participation compared with a standard second reminder. METHODS: In this randomized, controlled effectiveness trial, 9791 Danish women aged 30-64 who were due to receive the second reminder were equally randomized to either: 1) direct mailing of a second reminder and a self-sampling kit (directly mailed group); 2) mailing of a second reminder that offered a self-sampling kit to be ordered by e-mail, text message, phone, or webpage (opt-in group); or 3) mailing of a second reminder to attend regular cytology screening (control group). In an intention-to-treat analysis, we estimated the participation rate at 180 days post intervention, by returning a self-sample or attending regular cytology screening. We calculated the proportion of women with a positive HPV self-sample who attended for cervical cytology triage at the general practitioner within 90 days. RESULTS: Participation was significantly higher in the directly mailed group (38.0%) and in the opt-in group (30.9%) than in the control group (25.2%) (participation difference (PD): 12.8%, 95% CI: 10.6-15.0% and PD: 5.7%, 95% CI: 3.5-7.9%, respectively). Within 90 days, 107 women (90.7%, 95% CI: 83.9-95.3%) with a HPV-positive self-sample attended follow-up. CONCLUSIONS: Offering the opportunity of HPV self-sampling as an alternative to regular cytology screening increased participation; the direct mailing strategy was the most effective invitation strategy. A high compliance with follow-up was seen. TRIAL REGISTRATION: Current Controlled Trials NCT02680262 . Registered 10 February 2016.

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Cited by

Sorted by citations

Authors
Tranberg, M., Bech, B. H., Blaakær, J., Jensen, J. S., Svanholm, H., & Andersen, B.
Affiliations
  • Aarhus University (DK)
  • University of Southern Denmark (DK)
  • Statens Serum Institut (DK)
  • Regional Hospital Randers (DK)
Corresponding author
Tranberg, Mette
ORCID
Venue
BMC Cancer
Publisher
Springer Science and Business Media LLC
Published
2018-03-09
Volume
18
Issue
1
Pages
273-273
ISSN
1471-2407 (ISSN-L)
DOI
10.1186/s12885-018-4165-4
PMC
PMC5845195
OpenAlex
W2803053780
Cited by
92
References
3
Citations by year
2026: 7 · 2025: 11 · 2024: 14 · 2023: 9 · 2022: 16 · 2021: 18 · 2020: 8 · 2019: 4 · 2018: 5
FWCI
6.83
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Cancer (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • Scopus (Elsevier) (submittedVersion, other-oa)
Funders
  • Region Midtjylland
  • Regionshospitalet Randers
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, direct mail, cytology screening, follow-up attendance, women aged 30-49
MeSH terms
Adult, Uterine Cervical Dysplasia, Uterine Cervical Neoplasms, Denmark, Female, Follow-Up Studies, Humans, Middle Aged, Patient Participation, Postal Service, Prognosis, Research Design, Self Care, Specimen Handling, Vaginal Smears, Prevalence, Papillomaviridae, Papillomavirus Infections, Early Detection of Cancer, Intention to Treat Analysis

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