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Non-speculum sampling approaches for cervical screening in older women: randomised controlled trial
BACKGROUND: Cervical cancer disproportionately affects women ≥65 years, especially those not screened regularly. Speculum use is a key barrier. AIM: To assess if offering non-speculum clinician-taken sampling and self-sampling increases uptake for lapsed attenders aged 50–64 years. DESIGN AND SETTIN...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Royal College of General Practitioners
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8714504/ https://www.ncbi.nlm.nih.gov/pubmed/34972808 http://dx.doi.org/10.3399/BJGP.2021.0350 |
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author | Landy, Rebecca Hollingworth, Tony Waller, Jo Marlow, Laura AV Rigney, Jane Round, Thomas Sasieni, Peter D Lim, Anita WW |
author_facet | Landy, Rebecca Hollingworth, Tony Waller, Jo Marlow, Laura AV Rigney, Jane Round, Thomas Sasieni, Peter D Lim, Anita WW |
author_sort | Landy, Rebecca |
collection | PubMed |
description | BACKGROUND: Cervical cancer disproportionately affects women ≥65 years, especially those not screened regularly. Speculum use is a key barrier. AIM: To assess if offering non-speculum clinician-taken sampling and self-sampling increases uptake for lapsed attenders aged 50–64 years. DESIGN AND SETTING: Pragmatic randomised control trial conducted at 10 general practices in East London, UK. METHOD: Participants were 784 women aged 50–64 years, last screened 6–15 years before randomisation. Intervention participants received a letter offering the choice of non-speculum clinician- or self-sampling. Control participants received usual care. The main outcome measure was uptake within 4 months. RESULTS: Screening uptake 4 months after randomisation was significantly higher in the intervention arm: 20.4% (n = 80/393) versus 4.9% in the control arm (n = 19/391, absolute difference 15.5%, 95% confidence interval [CI] = 11.0% to 20.0%, P<0.001). This was maintained at 12 months: intervention 30.5% (n = 120/393) versus control 13.6% (n = 53/391) (absolute difference 17.0%, 95% CI = 11.3% to 22.7%, P<0.001). Conventional screening attendance within 12 months was very similar for both intervention 12.7% (n = 50/393) and control 13.6% (n = 53/391) arms. Ethnic differences were seen in screening modality preference. More White women opted for self-sampling (50.7%, n = 38/75), whereas most Asian and Black women and those from other ethnic backgrounds opted for conventional screening. CONCLUSION: Offering non-speculum clinician-taken sampling and self-sampling substantially increases uptake in older lapsed attendee women. Non-speculum clinician sampling appeals to women who dislike the speculum but still prefer a clinician to take their sample. Providing a choice of screening modality may be important for optimising cervical screening uptake. |
format | Online Article Text |
id | pubmed-8714504 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Royal College of General Practitioners |
record_format | MEDLINE/PubMed |
spelling | pubmed-87145042022-01-25 Non-speculum sampling approaches for cervical screening in older women: randomised controlled trial Landy, Rebecca Hollingworth, Tony Waller, Jo Marlow, Laura AV Rigney, Jane Round, Thomas Sasieni, Peter D Lim, Anita WW Br J Gen Pract Research BACKGROUND: Cervical cancer disproportionately affects women ≥65 years, especially those not screened regularly. Speculum use is a key barrier. AIM: To assess if offering non-speculum clinician-taken sampling and self-sampling increases uptake for lapsed attenders aged 50–64 years. DESIGN AND SETTING: Pragmatic randomised control trial conducted at 10 general practices in East London, UK. METHOD: Participants were 784 women aged 50–64 years, last screened 6–15 years before randomisation. Intervention participants received a letter offering the choice of non-speculum clinician- or self-sampling. Control participants received usual care. The main outcome measure was uptake within 4 months. RESULTS: Screening uptake 4 months after randomisation was significantly higher in the intervention arm: 20.4% (n = 80/393) versus 4.9% in the control arm (n = 19/391, absolute difference 15.5%, 95% confidence interval [CI] = 11.0% to 20.0%, P<0.001). This was maintained at 12 months: intervention 30.5% (n = 120/393) versus control 13.6% (n = 53/391) (absolute difference 17.0%, 95% CI = 11.3% to 22.7%, P<0.001). Conventional screening attendance within 12 months was very similar for both intervention 12.7% (n = 50/393) and control 13.6% (n = 53/391) arms. Ethnic differences were seen in screening modality preference. More White women opted for self-sampling (50.7%, n = 38/75), whereas most Asian and Black women and those from other ethnic backgrounds opted for conventional screening. CONCLUSION: Offering non-speculum clinician-taken sampling and self-sampling substantially increases uptake in older lapsed attendee women. Non-speculum clinician sampling appeals to women who dislike the speculum but still prefer a clinician to take their sample. Providing a choice of screening modality may be important for optimising cervical screening uptake. Royal College of General Practitioners 2021-12-31 /pmc/articles/PMC8714504/ /pubmed/34972808 http://dx.doi.org/10.3399/BJGP.2021.0350 Text en © The Authors https://creativecommons.org/licenses/by/4.0/This article is Open Access: CC BY 4.0 licence (http://creativecommons.org/licences/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ). |
spellingShingle | Research Landy, Rebecca Hollingworth, Tony Waller, Jo Marlow, Laura AV Rigney, Jane Round, Thomas Sasieni, Peter D Lim, Anita WW Non-speculum sampling approaches for cervical screening in older women: randomised controlled trial |
title | Non-speculum sampling approaches for cervical screening in older women: randomised controlled trial |
title_full | Non-speculum sampling approaches for cervical screening in older women: randomised controlled trial |
title_fullStr | Non-speculum sampling approaches for cervical screening in older women: randomised controlled trial |
title_full_unstemmed | Non-speculum sampling approaches for cervical screening in older women: randomised controlled trial |
title_short | Non-speculum sampling approaches for cervical screening in older women: randomised controlled trial |
title_sort | non-speculum sampling approaches for cervical screening in older women: randomised controlled trial |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8714504/ https://www.ncbi.nlm.nih.gov/pubmed/34972808 http://dx.doi.org/10.3399/BJGP.2021.0350 |
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