Under-screened women's reactions to at-home self-collected human papillomavirus test result delivery
- PMID: 41118505
- DOI: 10.1097/OLQ.0000000000002256
Under-screened women's reactions to at-home self-collected human papillomavirus test result delivery
Abstract
Background: Mailed self-collection kits for high-risk human papillomavirus (HPV) detection can increase access to cervical cancer screening among under-screened women. To design effective screening programs, it is necessary to evaluate women's understanding, reactions, and preferences for self-collected HPV test result delivery.
Methods: The My Body, My Test-3 trial assessed the effectiveness of mailed HPV self-collection kit outreach. Between 2016-2019, the trial enrolled low-income women aged 25-64 years in North Carolina overdue for cervical cancer screening. Our analytical sample included women from the intervention arm who conducted at-home self-collection, returned a self-collection kit, had a conclusive HPV result, and completed a follow-up survey after results were received by phone but before in-clinic screening. We evaluated women's understanding, reactions, and preferences for result delivery, stratified by result positivity.
Results: Among 296 diverse, low-income women, 16% (n = 47/296) had an HPV-positive result and 84% (n = 249/296) had an HPV-negative result. Most women understood their results as an indicator of cervical cancer risk, and 93% (n = 264/284 who responded) correctly recalled their results one-week post-receipt. Women with a positive result more frequently reported feeling afraid and worried, and less frequently reported feeling relieved, compared to those with a negative result (all p < .001). Most women were comfortable receiving results by phone (HPV-positive result: 85%, n = 40/47; HPV-negative result: 96%, n = 238/249), although some with a positive result had remaining questions.
Conclusions: Although most women delivered their mailed, self-collected HPV result by phone understood their result, future United States screening programs should provide educational support during and after HPV-positive result delivery.
Keywords: cervical screening; human papillomavirus; result delivery; self-collection; self-sampling.
Copyright © 2025 Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a “work of the United States Government” for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government.
Conflict of interest statement
Conflicts of Interest and Source of Funding: The National Cancer Institute of the US National Institutes of Health funded the My Body My Test-3 trial (5R01CA183891-03). Outside of the submitted work, Broshkevitch acknowledges past part-time employment by Merck & Co., Inc for a graduate research assistantship. Spees has received salary support paid to her institution for work on an unrelated research study from AstraZeneca. Wheeler has received unrelated grant funding from Pfizer and AstraZeneca paid to her institution in the last three years. Brewer serves as a voting member of CDC’s Advisory Committee on Immunization Practices. Smith has received research grants, supply donations, and consultancies for Hologic and BD Diagnostics, and supply donations from Rovers Medical Devices in the past 5 years. No other disclosures were reported.
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