Dissemination of at-home self-collection for HPV testing: Improving access to cervical cancer screening among under-screened Latina women

Background: Latinas have the highest cervical cancer incidence rates in the United States. Self-collection of samples at home to test for HPV, the primary cause of cervical cancer, is a promising strategy to improve screening access for under-screened women.

Objective: Identify effective dissemination strategies for HPV testing by at-home self-collection among Latina women. 

Methods: Study participants were low-income Latina women aged 30-64 years and overdue for cervical cancer screening. We recruited participants face-to-face and via flyers, community partners, and word-of-mouth referral. Participants self-collected a cervical-vaginal sample at home, returned the sample by mail or in person, and completed in-clinic Pap screening. Samples were tested for RNA of 14 high-risk HPV types.

Results: Among 78 women recruited to date, 74% returned self-collection kits and 72% completed Pap. Most women (69%) were recruited in-person by study staff and partners, followed by referral from friend/family member (22%) and flyers (8%). Most in-person recruitment (51%) occurred at a community flea market. Other successful recruitment sites included a domestic violence support group, parent school meetings, and Latino cultural and health fairs. Weekly communication with the outreach coordinator by text or phone was key to participant retention. Seven women (12%) tested HPV positive by self-collection, and two (4%) had high-grade precancerous lesions (CIN2+).

Conclusions: Latina women were willing to self-collect samples at home for later HPV testing, and had notably higher HPV and CIN2+ prevalence than the general population. Engagement of this population required considerable personal contact and navigation compared to previous studies with English speakers.