A randomized controlled trial in Singapore found that, compared with offering clinician sampling alone, offering self-sampling or clinician sampling increased both high-risk HPV detection (3.1% vs 0.3%) and overall screening uptake (56.6% vs 42.8%). A total of 650 women ages 30 to 69 due for cervical cancer screening were randomized to either an intervention arm or usual care arm (325 per arm). Study authors informed women in the intervention group about both methods and offered clinician sampling first, then self-sampling if they declined. Women in the usual-care group were offered clinician sampling only. Greater HPV detection in the intervention arm was largely attributable to screening uptake among previously unscreened women, who accounted for 7 of the 10 high-risk HPV cases; of these, five were detected through self sampling. Screening uptake increased particularly among women with no prior screening and among women with regular screening history. Among women in the intervention group who were screened, 56.4% chose self-sampling. Women with lower educational attainment were less likely to choose self-sampling over skipping screening altogether.
Why It Matters: Understanding how women weigh clinician sampling, self-sampling, and forgoing screening altogether can guide patient-centered efforts to reach under-screened groups.
Effect of Self-Sampling HPV DNA Testing on Cervical Cancer Screening in Singapore's Primary Care: Pragmatic Randomized Controlled Trial
Corresponding Author: Xin Rong Ng, MBBS, et al
NHG Polyclinics, NHG Health, Singapore
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
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