Online Program

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

Monday, November 2, 2015 : 10:50 a.m. - 11:10 a.m.

Andrea Des Marais, MPH, Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC
Lanya Shapiro, MSW, Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC
Noel Brewer, PhD, Department of Health Behavior, University of North Carolina, Gillings School of Global Public Health, Chapel Hill, NC
Lynn Barclay, BA, American Sexual Health Association, Research Triangle Park, NC
Jennifer Smith, PhD, Department of Epidemiology, University of North Carolina, Chapel Hill, NC
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. 

Learning Areas:

Provision of health care to the public

Learning Objectives:
Describe effective strategies for engaging under-screened Latina women to complete cervical cancer screening. Discuss the role that at-home self-collection for HPV testing could play in expanding cervical cancer screening uptake among rarely and never-screened Latina women.

Keyword(s): Cancer and Women’s Health, Cancer Prevention and Screening

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked as a project manager for 5 years on studies assessing the use of self-collection for HPV testing and other innovative methods for improving access to cervical cancer screening. My training is in Health Behavior with a focus on health education and outreach in the Latina community.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.