Human papillomavirus self-sampling with mRNA testing benefits routine screening.

Area of Science:

• Gynecology
• Public Health
• Oncology

Background:

• Cervical cancer screening attendance can be improved using novel methods.
• High-risk human papillomavirus (hrHPV) testing is a key component of modern cervical cancer screening strategies.
• Vaginal self-sampling offers a convenient alternative to clinician-collected samples.

Purpose of the Study:

• To evaluate the impact and feasibility of an opt-in hrHPV self-sampling program for non-attendees in Finland.
• To assess the uptake and effectiveness of self-sampling in increasing screening participation.
• To determine the prevalence of hrHPV and subsequent detection of high-grade squamous intraepithelial lesions (HSIL) in this population.

Main Methods:

• A randomized population of 5350 women who had not attended screening were invited to participate in an opt-in hrHPV self-sampling program.
• Self-collected vaginal samples were tested using the Aptima HPV mRNA assay, with positive samples further genotyped.
• Follow-up data on diagnosed HSIL were collected and compared to routine screening rates.

Main Results:

• 14.7% of invited women participated in self-sampling screening, with 24.0% expressing initial interest.
• 20.5% of self-taken samples tested positive for hrHPV.
• HSIL was diagnosed in 4.4% of HPV-positive women, a higher rate than observed in routine screening (0.5%).

Conclusions:

• Opt-in hrHPV self-sampling is a feasible and effective strategy to increase screening attendance among women who do not participate in routine screening.
• Self-sampling facilitates the detection of hrHPV and precancerous lesions in a population of non-attendees.
• This approach holds promise for improving cervical cancer prevention efforts in under-screened populations.