Trial reportInternational journal of cancer2025
Participation and relative cost of attendance by direct-mail compared to opt-in invitation strategy for HPV self-sampling targeting cervical screening non-attenders: A large-scale, randomized, pragmatic study.
Trial report in International journal of cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Cervical cancer screening strategies in women 65 years and older in the human papillomavirus era: A systematic review and meta-analysis of human papillomavirus-based testing and self-sampling approaches.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Pooled it
- Introducing self-sampling for cervical cancer screening: A regional implementation study in Pirkanmaa, Finland.Acta obstetricia et gynecologica Scandinavica · 2026Trial
- Trial
- Mailing Vaginal or Urine Self-Sampling Kits versus Conventional Invitation Letters: A Randomized Trial to Assess the Effect on Cervical Cancer Screening Attendance.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025Trial
- Cost-Effectiveness of HPV Self-Testing Options for Cervical Cancer Screening.JAMA network open · 2025Trial
- Participation and relative cost of attendance by direct-mail compared to opt-in invitation strategy for HPV self-sampling targeting cervical screening non-attenders: A large-scale, randomized, pragmatic study.International journal of cancer · 2025Trial
- Methodological considerations in the implementation of HPV self-sampling for cervical cancer screening.Acta obstetricia et gynecologica Scandinavica · 2026Article
- A global scoping review of interventions to increase participation in screening programmes for breast, cervical and colorectal cancer between 2016 and 2025.BMC public health · 2026Article
- Real-world evaluation of a population-based vaginal self-sampling program for cervical cancer prevention in Region Skåne, Sweden.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Large-Scale Study Comparing Analytical and Diagnostic Quality of Three HPV Self-Sampling Devices for At-Home Cervical Cancer Screening.APMIS : acta pathologica, microbiologica, et immunologica Scandinavica · 2025Article
- Cervical Cancer Screening Cascade: A Framework for Monitoring Uptake and Retention Along the Screening and Treatment Pathway.Current oncology (Toronto, Ont.) · 2025Review
- Building the foundations for an organized population-based cervical cancer screening program with primary HPV self-sampling in Catalonia, Spain: findings from a pilot implementation study.Frontiers in medicine · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Broad accessibility to cervical cancer screening and high participation rate is essential to reduce cervical cancer incidence. HPV self-sampling is an alternative to clinician collected cervical samples to increase accessibility and screening coverage. To inform on deployment strategies of HPV self-sampling, this large-scale, randomized, pragmatic study compared two invitation modalities; direct-mail and opt-in. The study included screening non-attenders from the Capital Region of Denmark randomly allocated (1:4) to a direct-mail or opt-in invitation for cervical screening by HPV self-sampling. Primary endpoint was screening participation; secondary endpoints were HPV prevalence and histology outcome. Adherence to follow-up and cost were also evaluated. After exclusion of hysterectomized/non-accessible women, 49,393 women were invited: 9639 by direct-mail, and 39,754 by the opt-in offer. A direct-mail invitation for HPV self-sampling yielded a significant higher participation than an opt-in invitation. HPV self-sample participation for direct-mail was 25.2% (n = 2426), opt-in participation was 20.2% (n = 8047), adjusted OR = 1.27, 95% CI 1.20-1.34. Participation increased with age (p < .0001) for both strategies and decreased with screening history of non-attendance (p < .0001). Interaction between invitation strategy and age/screening history was found; more women below 50 years of age participated by direct-mail compared to opt-in (p < .0001) and higher participation by direct-mail group was found in women with a short history of non-attendance (p < .0001). Participation of long-term unscreened women was similar between arms. The relative cost was ≈14 HPV self-sample kits distributed per additional participant by direct-mail over opt-in. HPV prevalence, adherence to follow-up, and detection of high-grade cervical intraepithelial neoplasia was similar between invitation strategies.
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