Self-sampling tools to increase cancer screening among underserved patients: a pilot randomized controlled trial

Area of Science:

• Oncology
• Public Health
• Preventive Medicine

Background:

• Cancer screening uptake is suboptimal and marked by disparities, particularly among underserved populations.
• Home-based self-sampling offers a strategy to overcome healthcare access barriers for colorectal and cervical cancer screening.
• Further research is needed on the feasibility and impact of self-sampling tools in diverse, underserved patient groups.

Purpose of the Study:

• To evaluate the effectiveness of home-based self-sampling kits for increasing colorectal and cervical cancer screening uptake.
• To assess screening outcomes and psychosocial factors associated with self-sampling among underserved patients.

Main Methods:

• A pilot randomized controlled trial was conducted with 48 women aged 50-65 years from federally qualified health centers in underserved rural areas.
• Participants were randomized to either standard care (reminder letters) or a self-sampling arm (fecal immunochemical tests and HPV tests).
• Uptake of screening, self-sampling outcomes, and psychosocial variables were assessed over a 10-week follow-up period.

Main Results:

• Self-sampling significantly increased colorectal cancer screening (75% vs. 13%) and cervical cancer screening (79% vs. 8%) compared to standard care.
• Among those returning kits, abnormal findings were detected in 24% for colorectal and 18% for cervical cancer screening.
• Increased cancer screening knowledge was positively associated with higher screening uptake.

Conclusions:

• Home-based self-sampling tools are effective in boosting colorectal and cervical cancer screening rates among unscreened, underserved patients.
• Implementing self-sampling strategies can enhance primary care delivery and improve cancer detection in vulnerable populations.