HPV self-collection kit enhances testing for undertested and underserved women in North Carolina

Jennifer S. Smith, Ph.D., UNC Gillings International School of Public Health, UNC School of Medicine, Lineberger Comprehensive Cancer Center, who led a phase 3 controlled trial, said self-collection kits and scheduling assistance are key to reaching these populations. And it also leads to the prevention of cervical cancer.

Chapel Hill, North Carolina – Five years ago, the World Health Organization (WHO) issued a global call to eradicate cervical cancer. Almost all cervical cancers are caused by primary infection with an oncogenic type of human papillomavirus (HPV), so viral screening is essential for the prevention and treatment of this disease.

However, offering HPV screening only within clinical settings may limit access to screening for many underserved women across the United States and here in North Carolina.

Dr. Jennifer S. Smithand other researchers Gillings International School of Public Health The UNC School of Medicine and the UNC School of Medicine are working across North Carolina to find out if under-tested and under-served women are more likely to get cervical cancer if they: conducted an open-label, two-arm, randomized controlled trial called ‘My Body, My Test-3’. Mailed HPV self-collection kits and provided scheduling assistance.

Researchers found that mail-in HPV self-sampling and scheduling assistance led to more cervical cancer screening than scheduling alone. “My Body, My Test-3” Survey Results Published of lancet public health.

“Women who are undertested can take the time to complete and return HPV self-collection kits, find the process acceptable, and see if it is actually a test for cervical cancer. We have shown that it has led to re-participation in ,” said Professor Smith. is a professor of Department of Epidemiology. “Our study was particularly unique because he used two levels of intervention to increase screening uptake.”

HPV is the most common sexually transmitted disease. In most cases, HPV goes away on its own within a few years and does not cause any health problems.

However, for some people, the infection can promote precancerous lesions and abnormal cell development in the cervix. If a doctor knows a patient has HPV-related cervical lesions in her, they can quickly remove the lesions and reduce the risk of developing cervical cancer.

According to Smith, the biggest risk factor for cervical cancer is missing cervical cancer screening deadlines, and those without health insurance and financial security to cover the cost of testing and in-person visits. People who don’t have it are more likely to do so.

“Many cervical cancer cases in the United States are not screened regularly or at all due to lack of insurance, transportation barriers, or lack of knowledge of statewide screening programs. It’s happening among women who haven’t, and you can get screened for free or on a sliding scale,” Smith said.

Mailing in self-collection kits can help break down these access barriers. This technique uses a simple collection device such as a brush or swab to collect a cervicovaginal cell sample for testing for HPV infection. The HPV test itself is as good as a doctor’s test for detecting high-grade precancerous lesions or cancers of the cervix.

One of the benefits of self-collection is that it eliminates the need to perform a pelvic exam first in the clinic and can be done at home or another location convenient for the patient. Those with positive HPV results are referred to follow-up care at the clinic.

As part of the trial, 665 women were contacted to help book an exam at a nearby clinic. One group of women was provided with scheduling assistance only, allowing researchers to determine whether the intervention was successful on its own.

The remaining group of women were also given an HPV self-collection kit with illustrated instructions and a self-collection brush. They were given a stamped envelope to return the samples for laboratory testing.

The idea of ​​self-collection is not new. Self-collection is already used in national programs around the world, such as Denmark and the Netherlands. However, self-collection in the United States is still under review by the Food and Drug Administration (FDA).

The researchers hope that the evidence from this trial will help give further impetus to the FDA’s approval of HPV self-collection. Identify undertested people and perform HPV self-collection, if self-collection is approved by national laboratories, programs, Medicaid, federally qualified health centers, and community organizations such as breast and cervical cancer control programs may be used to By mail or within the clinical setting.

For Smith, the trial was very valuable in that it was a challenging learning experience about how to contact women whose cervical cancer screening was overdue. They recruited women to participate in screening trials using a variety of community outreach methods, including social media, radio, and local bus flyers.

Inevitably, it’s important for doctors, researchers, and programs to find interventions and testing strategies that are tailored to women who need testing, Smith said.

“Until we find women who aren’t being screened and make sure they’re being screened, we can’t make an impact in reducing cervical cancer in North Carolina and globally,” Smith said. “We need to work with them. Our results show that mailing her HPV self-collection kit to a woman who is not being screened regularly increases her cervical cancer screening rate by 2. We have shown that it will double.”

The researchers will now consider the best approach for providing HPV self-sampling assistance. For example, patients can flag that they are overdue for screening through their medical records, and kits could be delivered in the mail or delivered in person when visiting a clinic for other services. I have.

As more programs consider comprehensive self-collection as part of patient care, there is a growing need for cervical cancer screening, from increasing access to screening to providing the necessary follow-up care for positive self-test results. Smith believes it is important to consider the entire cascade of

“It’s important to ensure that women have access to their health care provider if they have questions about the self-collection process or its results,” Smith said. “If the self-test result is positive, we need to ensure that appropriate follow-up care is available for good patient care.”

other authors of lancet public health The paper is by Peyton K. Pretsch, MPH, Lisa P. Spieth, PhD, Noel Brewer, PhD, Michael G. Hudgens, PhD, Busora Sanusi, MA, Eliane Lohner PhD, Elise Miller, MPH, Sarah L. Jackson, MPH, Dr. Stephanie B. Wheeler, MPH, UNC. Lynne Berkley, American Association for Sexual Health, Research Triangle Park, NC, and Alicia Carter, MD, Laboratory Corporation of America Holdings, Burlington, NC.

Media contact: Kendall DanielsCommunications Specialist, UNC Health | UNC School of Medicine