Self-sampling tools to increase cancer screening among underserved patients: A pilot randomized controlled trial
Mené aux Etats-Unis auprès de 48 participantes ayant des difficultés d'accès aux soins de santé (âge : 50 à 65 ans), cet essai évalue l'intérêt de l'auto-prélèvement pour améliorer le taux de participation au dépistage du cancer colorectal ou du cancer du col utérin
Screening can reduce cancer mortality, but uptake is suboptimal and characterized by disparities. Home-based self-sampling can facilitate screening for colorectal cancer (with stool tests, eg, fecal immunochemical tests [FIT]) and for cervical cancer (with self-collected human papillomavirus [HPV] tests), especially among patients who face barriers to accessing healthcare. Additional data are needed on feasibility and potential effects of self-sampling tools for cancer screening among underserved patients.We conducted a pilot randomized controlled trial with patients (female, ages 50-65, out-of-date with colorectal and cervical cancer screening) recruited from federally-qualified health centers in rural and racially-segregated counties in Pennsylvania. Participants in the Standard of care arm (n = 24) received screening reminder letters. Participants in the Self-sampling arm (n = 24) received self-sampling tools for FIT and HPV testing. We assessed uptake of screening (10-week follow-up), self-sampling screening outcomes, and psychosocial variables. Analyses used Fisher’s exact tests to assess the effect of study arm on outcomes.Cancer screening was higher in the Self-sampling arm than the Standard of care arm (colorectal: 75% vs 13%, respectively, odds ratio [OR]=31.32, 95% confidence interval [CI]=5.20-289.33; cervical: 79% vs 8%, OR = 72.03, 95% CI = 9.15-1141.41). Among participants who returned the self-sampling tools, the prevalence of abnormal findings was 24% for colorectal and 18% for cervical cancer screening. Cancer screening knowledge was positively associated with uptake (p<.05).Self-sampling tools can increase colorectal and cervical cancer screening among unscreened, underserved patients. Increasing the use of self-sampling tools can improve primary care and cancer detection among underserved patients.STUDY00015480.
JNCI Cancer Spectrum , article en libre accès, 2022