Effect of direct mailing self-sampling kits on participation in the Dutch hrHPV-based cervical screening programme: a...

Area of Science:

• Public Health
• Oncology
• Screening Programs

Background:

• The Dutch cervical cancer screening program updated its strategy in July 2023.
• The new policy involves direct mailing of self-sampling kits to all age groups, with specific focus on 30-year-olds and reminders for non-participants.

Purpose of the Study:

• To evaluate the impact of the new direct mailing policy on cervical cancer screening participation.
• To assess changes in self-sampling uptake and follow-up testing rates.

Main Methods:

• Utilized data from national screening (ScreenIT) and pathology (Palga) databases.
• Compared invited individuals from July-December 2023 with a control group from the same period in 2022.
• Analyzed participation rates, time to participation, self-sampling uptake, and reflex cytology participation, stratified by age and screening history.

Main Results:

• Overall participation increased from 42.1% to 49.9% (RR: 1.19).
• Participation surged among 30-year-olds (30.6% to 40.3%) and first-time participants (6.8% to 9.1%).
• Vaginal self-sampling uptake rose significantly from 21.9% to 61.9% (RR: 2.82), with highest uptake among first-time participants and 30-34-year-olds.

Conclusions:

• Direct mailing of self-sampling kits is an effective strategy to enhance participation in population-based cervical cancer screening.
• The policy particularly benefits first-time invitees and previous non-attenders.
• Maintaining reflex cytology participation among high-risk HPV-positive individuals is crucial for maximizing screening effectiveness.