A mail-based human papillomavirus (HPV) self-testing program appears to be a promising approach to screening women in Appalachia, according to a pilot study published online Nov. 19 in Sexually Transmitted Diseases.
Paul L. Reiter, Ph.D., from The Ohio State University in Columbus, and colleagues recruited 103 women from Appalachian Ohio (aged 30 to 65 years and no Pap test in at least three years) to participate in a pilot mail-based testing program. Women were mailed an HPV self-test and were randomly assigned to receive either self-test instructions developed by the device manufacturer and a standard information brochure about cervical cancer (control group) or self-test instructions developed by the Health Outcomes through Motivation and Education Project and a photo story information brochure about cervical cancer (intervention group).
The researchers found that 78 percent of women returned their HPV self-test, with similar rates seen between the two groups (odds ratio, 1.09; 95 percent confidence interval, 0.43 to 2.76). More than one-fourth of returners (26 percent) had an oncogenic HPV type detected in their sample. Participants reported high levels of satisfaction and positive experiences with the self-testing process. Only 11 percent of the women received a Pap test, with similar rates seen between the groups (odds ratio, 1.91; 95 percent confidence interval, 0.52 to 6.97).
"Mail-based HPV self-testing programs are a potentially promising strategy for reaching underscreened women in Appalachia," the authors write. "Efforts are needed to better understand how to optimize the success of such programs."