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Cost-Effectiveness of HPV Self-Testing Options for Cervical Cancer Screening.

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JAMA Network Open
|October 1, 2025
PubMed
Summary
This summary is machine-generated.

Directly mailing human papillomavirus (HPV) self-sampling kits is a cost-effective strategy for increasing cervical cancer screening in adherent and overdue individuals. This approach proves efficient and affordable for public health outreach.

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Area of Science:

  • Public Health
  • Health Economics
  • Gynecologic Oncology

Background:

  • Mailed human papillomavirus (HPV) self-sampling kits increase cervical cancer screening in underscreened populations and can be cost-effective.
  • Previous cost-effectiveness evaluations have not comprehensively assessed this strategy across diverse screening histories.

Purpose of the Study:

  • To conduct an economic evaluation, including cost-effectiveness and budget impact analyses, of mailed HPV self-sampling kits.
  • To assess the strategy's value among individuals with adherent, overdue, or unknown cervical cancer screening histories within a US healthcare system.

Main Methods:

  • A randomized clinical trial (RCT) informed a cost-effectiveness analysis (CEA) and budget impact analysis (BIA).
  • Intervention costs were calculated from healthcare system and Medicare perspectives.
  • Participants included 31,355 female members aged 30-64 years, randomized by screening history (adherent, overdue, unknown).

Main Results:

  • Direct mailing of HPV kits was the most effective and cost-saving strategy for screening-adherent and overdue individuals.
  • For overdue individuals, direct mailing generated additional screens at a cost ranging from -$19 (cost-saving) to $63.
  • For individuals with unknown screening history, an opt-in approach generally dominated usual care, proving more effective and cost-saving.

Conclusions:

  • Directly mailing HPV self-sampling kits is an economically dominant strategy for screening-adherent and overdue populations.
  • The program's costs demonstrated rapid decline over a 4-year period.
  • Mailed HPV kits represent an effective, efficient, and affordable outreach strategy for cervical cancer screening.