Self-sampling for HPV testing in primary care
Self-sampling for HPV (human papillomavirus) testing can overcome many of the barriers associated with cervical screening, including embarrassment, discomfort and the need to attend appointments.
It enables women to take a sample at a time and place of their choosing, without a pelvic examination. Although there are drawbacks in test performance, these would be offset by the increase in screening coverage.
Various approaches have been studied including sending self-sampling kits directly to women or asking women to order kits over the phone. Response rates have been variable (8.7-52.1%) and it is unclear what the most effective approach is. Although GPs and nurses offer vulvo-vaginal self-testing kits opportunistically as part of the National Chlamydia Screening Programme, such an approach has not been evaluated for cervical screening non-attenders.
It has the advantage of in-person contact with a population who are difficult to engage and fewer wasted self-sampling kits because they are handed directly to women.
Given the busy and complex clinical setting of GP primary care, we are carrying out a pilot study to determine the feasibility and acceptability of offering self-sampling to non-attenders in primary care. The pilot will serve to address practical and logistical issues and will help streamline the design for a larger randomised trial.
Other projects include: Novel cervical screening technologies and DNA methylation as a biomarker to detect high grade anal intraepithelial neoplasia.
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