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Mailed Human Papillomavirus Self-Collection With Papanicolaou Test Referral for Infrequently Screened Women in the United States.

Smith, Jennifer S. PhD, MPH; Des Marais, Andrea C. MPH; Deal, Allison M. MS; Richman, Alice R. PhD, MPH; Perez-Heydrich, Carolina PhD, MPH; Yen-Lieberman, Belinda MD; Barclay, Lynn BA; Belinson, Jerome MD; Rinas, Allen MS CT (SCT), CM (IAC); Brewer, Noel T. PhD
Sexually Transmitted Diseases: Post Author Corrections: July 26, 2017
doi: 10.1097/OLQ.0000000000000681
Original Study: PDF Only

Background: Testing for high-risk human papillomavirus (HPV) infection using mailed, self-collected samples is a promising approach to increase screening in women who do not attend clinic screening at recommended intervals.

Methods: To assess this intervention among high-risk women in the United States, 429 women without a Papanicolaou (Pap) test in 4 or more years (overdue by US guidelines) were recruited from the general population. Participants aged 30 to 65 years were mailed a kit to self-collect a cervicovaginal sample at home, return the sample by mail, and receive HPV results by telephone, with referral to follow-up cytological Pap testing at a local clinic. Cervicovaginal self-samples were collected with a Viba brush, stored in Scope mouthwash, and tested by Hybrid Capture 2. Data were collected in 2010 to 2011 and analyzed in 2017.

Results: Two-thirds (64%) of participants returned a self-collected sample, of whom 15% tested HPV DNA positive. Human papillomavirus self-test-positive women reported higher rates of follow-up Pap tests (82%) than did those with self-test negative results (51%). No demographic differences were found in self-test return rate or HPV positivity. High acceptability was reported in participant surveys: most women (81%) had "mostly positive" overall thoughts about the self-test, and most reported being comfortable receiving the kit in the mail (99%), returning their self-collected sample by mail (82%), and receiving their test results by telephone (97%).

Conclusions: Conducting HPV self-testing through population-based recruitment, mailed kit delivery and return by mail, and results delivery by telephone has the potential to reach a broad segment of US underscreened women.

(C) Copyright 2017 American Sexually Transmitted Diseases Association