在阿巴拉契亚地区开展基于邮件的 HPV 自我收集计划以提高宫颈癌筛查率:小组随机试验结果。

IF 3.7 3区 医学 Q2 ONCOLOGY Cancer Epidemiology Biomarkers & Prevention Pub Date : 2024-10-24 DOI:10.1158/1055-9965.EPI-24-0999
Paul L Reiter, Abigail B Shoben, Sarah Cooper, Amie M Ashcraft, Emma McKim Mitchell, Mark Dignan, Mark Cromo, Jean Walunis, Deborah Flinner, Dannell Boatman, Lindsay Hauser, Mack T Ruffin, Jerome L Belinson, Roger T Anderson, Stephenie Kennedy-Rea, Electra D Paskett, Mira L Katz
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引用次数: 0

摘要

背景:尽管邮寄人乳头瘤病毒(HPV)自采项目有望提高宫颈癌筛查率,但在美国进行评估的项目很少。我们报告了针对生活在阿巴拉契亚地区筛查不足的妇女开展的基于邮件的 HPV 自我收集计划的结果:方法:2021-2022 年期间,我们在肯塔基州、俄亥俄州、弗吉尼亚州和西弗吉尼亚州的阿巴拉契亚地区开展了一项团体随机试验。参与者为 30-64 岁、宫颈癌筛查不足的女性,来自参与试验的医疗系统。干预组的参与者(人数=464)会被邮寄HPV自取试剂盒,随后(如有需要)还会接受电话患者指导;常规护理组的参与者(人数=338)会被邮寄一封提醒信,提醒她们接受诊所提供的宫颈癌筛查测试。广义线性混合模型比较了各研究组的宫颈癌筛查情况:总体而言,干预组中有 14.9% 的参与者接受了宫颈癌筛查,常规护理组中有 5.0% 的参与者接受了宫颈癌筛查。与常规护理组相比,邮寄 HPV 自我收集干预措施提高了宫颈癌筛查率(OR=3.30,95% CI:1.90-5.72,p=0.005)。在 10.5%退回的 HPV 自采试剂盒中检测到一种或多种高危 HPV 类型。在患者导航员尝试联系的干预组参与者中,44.2%的人成功联系上了患者导航员:结论:HPV自采提高了宫颈癌筛查率,今后需要努力确定如何优化此类项目,包括提供患者指导服务:影响:基于邮件的 HPV 自我收集计划是提高阿巴拉契亚地区筛查不足妇女宫颈癌筛查率的可行策略。
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A Mail-Based HPV Self-Collection Program to Increase Cervical Cancer Screening in Appalachia: Results of a Group Randomized Trial.

Background: Despite the promise of mail-based human papillomavirus (HPV) self-collection programs for increasing cervical cancer screening, few have been evaluated in the United States. We report the results of a mail-based HPV self-collection program for underscreened women living in Appalachia.

Methods: We conducted a group randomized trial during 2021-2022 in the Appalachian regions of Kentucky, Ohio, Virginia, and West Virgnia. Participants were women ages 30-64 who were underscreened for cervical cancer and from a participating health system. Participants in the intervention group (n=464) were mailed an HPV self-collection kit followed by telephone-based patient navigation (if needed), and participants in the usual care group (n=338) were mailed a reminder letter to get a clinic-based cervical cancer screening test. Generalized linear mixed models compared cervical cancer screening between study groups.

Results: Overall, 14.9% of participants in the intervention group and 5.0% of participants in the usual care group were screened for cervical cancer. The mail-based HPV self-collection intervention increased cervical cancer screening compared to the usual care group (OR=3.30, 95% CI: 1.90-5.72, p=0.005). One or more high-risk HPV types were detected in 10.5% of the returned HPV self-collection kits. Among participants in the intervention group who patient navigators attempted to contact, 44.2% were successfully reached.

Conclusions: HPV self-collection increased cervical cancer screening, and future efforts are needed to determine how to optimize such programs, including the delivery of patient navigation services.

Impact: Mail-based HPV self-collection programs are a viable strategy for increasing cervical cancer screening among underscreened women living in Appalachia.

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来源期刊
Cancer Epidemiology Biomarkers & Prevention
Cancer Epidemiology Biomarkers & Prevention 医学-公共卫生、环境卫生与职业卫生
CiteScore
6.50
自引率
2.60%
发文量
538
审稿时长
1.6 months
期刊介绍: Cancer Epidemiology, Biomarkers & Prevention publishes original peer-reviewed, population-based research on cancer etiology, prevention, surveillance, and survivorship. The following topics are of special interest: descriptive, analytical, and molecular epidemiology; biomarkers including assay development, validation, and application; chemoprevention and other types of prevention research in the context of descriptive and observational studies; the role of behavioral factors in cancer etiology and prevention; survivorship studies; risk factors; implementation science and cancer care delivery; and the science of cancer health disparities. Besides welcoming manuscripts that address individual subjects in any of the relevant disciplines, CEBP editors encourage the submission of manuscripts with a transdisciplinary approach.
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