Operational experiences from the general implementation of HPV self-sampling to Danish screening non-attenders

• Published in: Preventive medicine 2022-07, Vol.160, p.107096-107096, Article 107096
• Main Authors: Ejegod, Ditte Møller, Pedersen, Helle, Pedersen, Birgitte Tønnes, Serizawa, Reza, Bonde, Jesper
• Format: Article
• Language: English
• Subjects: Cervical cancer screening; HPV self-sampling; Opt-in; Participation
• ISSN: 0091-7435; 1096-0260
• DOI: 10.1016/j.ypmed.2022.107096

The Danish cervical cancer screening program is a cost-free cancer prevention program for all Danish resident women aged 23–64 years. The coverage is 73%, but screening attendance is slowly declining. Notwithstanding, almost half of all newly diagnosed cervical cancers are found amongst screening non-attenders. To increase screening attendance, the Capital Region of Denmark implemented HPV self-sampling as an alternative offer to women not attending the regular screening offer. This was an opt-in offer to 57,717 screening non-attending women in 2017–2018. They received an invitation letter and could opt-in by letter, phone, e-mail, or website. Invitation and return-of-kit reminders were used in the set-up. HPV positive women were recommended to go to their General Practitioner (GP) for a follow-up sample. HPV negative women returned to the ordinary screening program. Of all invited women, 15,501 opted-in (27%). The purpose designed website was the most frequent used method of response, 63% opted in by the HPV-self sampling website. Use of invitation and return-of-kit reminders generated 8.6% and 6.1% additional responses and participation, respectively, underlining the importance of timely communication. Overall, 17% returned the HPV self-sampling kit for analysis. In addition, 14% had a regular clinician collected screening sample after receiving the invitation for self-sampling, leading to a total screening of 31% of the invited women. HPV prevalence was 15% and 92% of the women positive for HPV adhered to the recommended follow-up. •The HPV self-sampling offer to non-attenders generated a total participation of 31%.•Of all invited to HPV self-sampling 17% returned the HPV self-sample for analysis.•Additional 14% had a sample taken by clinician after the HPV self-sampling offer.•The HPV self-sample webpage was the main method to order an HPV self-sampling kit.•Invitation and return-of-kit reminders increased HPV self-sampling participation rate.