HPV self-sampling screening raises detection in Singapore trial
A Singapore randomized trial found offering self-sampling lifted high-risk HPV detection and cervical screening uptake versus clinician sampling alone.
By Tom Brennan · Health & Medicine Correspondent
3 min read
Offering HPV self-sampling screening as an option increased both high-risk HPV detection and cervical cancer screening participation in a randomized trial in Singapore. The findings matter because the gains were tied in large part to women who had not previously been screened, according to a study published in The Annals of Family Medicine.
The trial included 650 women ages 30 to 69 who were due for cervical cancer screening, the study authors reported. Researchers assigned 325 women to an intervention group and 325 to a usual-care group.
Women in the intervention group were told about both clinician sampling and self-sampling. They were offered clinician sampling first, and if they declined, they were then offered self-sampling. Women in the usual-care group were offered clinician sampling only.
What did the HPV self-sampling study find?
The intervention group had a high-risk HPV detection rate of 3.1%, compared with 0.3% in the usual-care group, according to the study. Screening uptake also rose: 56.6% of women in the intervention group were screened, versus 42.8% of those offered clinician sampling alone.
Self-sampling also became the preferred route among many women who completed screening in the intervention arm. Of the screened women in that group, 56.4% chose self-sampling, the authors reported.
The study authors said the higher detection rate was largely linked to participation by women who had not been screened before. Previously unscreened women accounted for seven of the 10 high-risk HPV cases found in the intervention group, and five of those seven cases were identified through self-sampling.
Who appeared to benefit most?
Screening uptake increased particularly among women with no prior screening and among women who already had a regular screening history, according to the Annals of Family Medicine paper. The findings suggest that adding an option after a declined clinician sample can bring in some patients who otherwise would not be screened.
The study also found a difference by education level. Women with lower educational attainment were less likely to choose self-sampling instead of skipping screening altogether, the authors reported.
That detail may be relevant for primary care programs considering how to offer the option. The trial tested a specific sequence: discuss both methods, offer clinician collection first, then offer self-sampling if the patient declines.
What is self-sampling HPV testing?
In this trial, self-sampling meant women could choose a patient-collected sample for HPV DNA testing after declining clinician sampling. Clinician sampling referred to the usual-care method offered by a health professional.
The study was published under the title “Effect of Self-Sampling HPV DNA Testing on Cervical Cancer Screening in Singapore’s Primary Care: Pragmatic Randomized Controlled Trial.” The American Academy of Family Physicians, which summarized the findings, described the trial as a comparison between offering self-sampling plus clinician sampling and offering clinician sampling alone.
This story draws on original reporting from Medical Xpress.