Opt-in approach with option to request a self-sampling kit minimally increases screening uptake
By Elana Gotkine HealthDay Reporter
THURSDAY, Nov. 30, 2023 (HealthDay News) — For individuals who are due or overdue for cervical cancer screening, direct-mail human papillomavirus (HPV) self-sampling increases screening uptake, according to a study published in the Nov. 28 issue of the Journal of the American Medical Association.
Rachel L. Winer, Ph.D., M.P.H., from the University of Washington in Seattle, and colleagues examined the effectiveness of direct-mail and opt-in approaches for offering HPV self-sampling kits to individuals by cervical cancer screening history (due for screening, overdue, or unknown) in a randomized clinical trial involving women aged 30 to 64 years. Individuals stratified as due were randomly assigned to receive usual care (patient reminders and clinician electronic health record alerts), education (usual care plus educational materials), direct mail (usual care plus educational materials plus a mailed self-sampling kit), or opt-in (usual care plus educational materials and the option to request a kit; 3,671; 3,960; 1,482; and 3,956 participants, respectively). Individuals who were overdue were randomly assigned to usual care, education, or direct mail (5,488; 1,408; and 1,415 participants, respectively). Individuals with unknown screening history were randomly assigned to usual care, education, or opt-in (2,983; 3,486; and 3,506, respectively).
The researchers found that among those due for screening, screening completion was 14.1 and 3.5 percent higher in the direct-mail and opt-in groups, respectively, compared with receiving education alone. Screening completion was 16.9 percent higher in the direct-mail versus education-alone group among overdue individuals. Screening was 2.2 percent higher for the opt-in versus the education-alone group among those with unknown history.
“To increase screening adherence, systems implementing HPV self-sampling should prioritize direct-mail outreach for individuals who are due and overdue for screening,” the authors write.
Two authors disclosed ties to UnitedHealthcare.
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