Journal Article

Vaginal self-sampling is a cost-effective way to increase participation in a cervical cancer screening programme: a randomised trial

Pigneaux de Laroche, N, Goudeau, A, Rusch, E, Giraudeau, B, Fontenay, R, Haguenoer, K, Marret, H, Boyard, J, Gaudy-Graffin, C, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)) ; Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Sengchanh, S

2014

Overview

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.

• Publisher: CCSD,Cancer Research UK,Nature Publishing Group UK,Nature Publishing Group
• Subject: 692/699/67/1517/1371 / 692/699/67/2322 / 692/700/3934 / Adult / Aged / Biological and medical sciences / Biomedical and Life Sciences / Biomedicine / Cancer Research / Cervical cancer / Cost-Benefit Analysis / Drug Resistance / Early Detection of Cancer - methods / Epidemiology / Female / Female genital diseases / Follow-Up Studies / Gynecology. Andrology. Obstetrics / Human papillomavirus / Humans / Life Sciences / Medical sciences / Middle Aged / Molecular Medicine / Multiple tumors. Solid tumors. Tumors in childhood (general aspects) / Oncology / Patient Participation / Reagent Kits, Diagnostic / Santé publique et épidémiologie / Statistics / Tumors / Uterine Cervical Neoplasms / Vaginal Smears - economics / Vaginal Smears - methods