The impact of offering multiple cervical screening options to women whose screening was overdue in Dumfries and Galloway, Scotland

L Wedisinghe; P Sasieni; H Currie; G Baxter

doi:10.1016/j.pmedr.2022.101947

The impact of offering multiple cervical screening options to women whose screening was overdue in Dumfries and Galloway, Scotland

Prev Med Rep. 2022 Aug 11:29:101947. doi: 10.1016/j.pmedr.2022.101947. eCollection 2022 Oct.

Authors

L Wedisinghe^{1

2}, P Sasieni³, H Currie², G Baxter^{2

4}

Affiliations

¹ Department of Obstetrics and Gyanecology, Central Queensland Hospital and Health Service, Rockhampton, QLD 4700, Australia.
² NHS Dumfries and Galloway, Dumfries and Galloway Royal Infirmary, Dumfries DG2 8RX, United Kingdom.
³ School of Cancer and Pharmaceutical Sciences, King's College London, Great Maze Pond, London SE1 9RT, United Kingdom.
⁴ North Cumbria Integrated Care NHS Foundation Trust, Newtown Road, Carlisle CA2 7HY, United Kingdom.

Abstract

Most women who develop cancer have not been screened regularly. One in four women in Scotland, is overdue for cervical screening. Aim was to assess the impact of offering multiple cervical screening options to women whose screening is overdue. A prospective cohort study including all women whose screening was overdue, aged 30-60 years in Dumfries and Galloway in 2012. Potentially eligible women (n = 4146) were identified split into six groups. Women aged 30-55 years were allocated to three different groups. Group 1 (letter, n = 1246), Group 2 (letter and kit, n = 221), Group 3 (letter, n = 2031). Women aged 56-60 years were allocated to: Group 4 (letter, n = 292), Group 5 (letter and kit, n = 292) and Group 6 (control, n = 64). Women who self-collected a vaginal sample were requested to complete a questionnaire. The percentages of women responding were 24 % (21-26), 32 % (25-38), 16 % (14-18), 15 % (11-20) and 12 % (9-17) in groups 1 to 5 respectively, compared with 3 % (0-11) among controls. A significantly higher number of women (n = 383, 10 % of 3815) opted for self-sampling in comparison with undergoing a cervical screening test (CST) at the GP practice (n = 197, 5 %, x² = 59.0, p < 0.0001). The Evalyn® Brush was well accepted (218/313 = 70 %) by those who requested self-sampling. Almost all (265/272 = 97 %) women who self-collected a vaginal sample said that if they had the option of self-sampling, they would regularly participate in future cervical screening. Offering more flexible screening options, self-sampling in particular, appears to increase cervical screening participation.

Keywords: CIN, Cervical intraepithelial neoplasia; CST, Cervical screening test; Cervical cancer screening; Cervical screening uptake rate; Cervical smear testing non-responder; Cervix unscreened women in Dumfries and Galloway; GP, General practice; HPV, Human papillomavirus; Human papillomavirus; LBC, Liquid-based cytology; NHS, National Health Service; National Health Service Scotland; PCR, Polymerase chain reaction; SS, Self-sampling; Screening overdue; Self-collection kit; Vaginal self-sampling for HPV screening.

Abstract

Grants and funding