Out-reach Colposcopy Clinics and HPV Self-Sampling Decreases Loss to Follow up in a Community based Cervical Cancer...

Area of Science:

• Gynecology
• Public Health
• Oncology

Background:

• Cervical cancer screening programs face challenges with follow-up adherence among HPV-positive women.
• Traditional screening follow-up methods often result in high default rates, hindering effective disease management.
• Improving patient engagement is crucial for the success of community-based cervical cancer prevention strategies.

Purpose of the Study:

• To evaluate the effectiveness of HPV self-sampling and outreach colposcopy clinics in enhancing follow-up rates for HPV-positive women.
• To compare the default rates between standard follow-up and the implemented interventions.
• To assess women's preference and acceptance of HPV self-sampling for follow-up.

Main Methods:

• A prospective observational study involving 2977 women undergoing cervical cancer screening with the CareHPV test.
• HPV-positive women were offered follow-up colposcopy at a rural health center or through outreach clinics in their villages.
• A one-year follow-up protocol included options for HPV testing by a healthcare worker (HCW) or self-sampling, with compliance and preference data collected.

Main Results:

• The HPV screen-positive rate was 7.05%. Initial colposcopy rates at the rural health center were 28.5%, increasing to 45.2% with outreach clinics.
• Introduction of self-sampling for follow-up increased participation from 40.5% to 60%.
• All women offered self-sampling preferred it over HCW-collected samples; 16.2% remained HPV positive at 12-14 months.

Conclusions:

• HPV self-sampling is an effective strategy for the follow-up of HPV-positive women within community screening programs.
• Outreach colposcopy clinics held in villages significantly improve follow-up rates and patient adherence.
• These interventions demonstrate potential to enhance cervical cancer prevention efforts by improving the management of HPV-positive individuals.