To assess opt-in and sample return rates for home cervical cancer screening in a diverse, community-based population.
Approach:
Study Design: Cohort study approved by the Kaiser Permanente Northern California institutional review board, following STROBE guidelines.
Participants: Patients aged 25 to 62 years offered home screening via email, excluding pregnant individuals and those with existing appointments.
Data Collection: Patients received a screening kit for vaginal self-collection, with HPV testing conducted by a processing laboratory.
Outcomes: Primary outcomes were opt-in rate and sample return rate, analyzed using adjusted prevalence ratios.
Key Findings:
A total of 13,714 patients were offered home screening; 2.3% of those with unknown screening history were found to be overdue.
18.6% opted to receive kits, with higher rates among older patients, those with higher comorbidity, and White patients.
54.0% of patients returned samples within 60 days, with return rates associated with older age and known screening history.
Interpretation:
Participation in home screening was influenced by demographic factors, with lower opt-in and return rates among certain groups, indicating potential disparities in health system engagement.
Limitations:
Exclusion of patients deemed overdue, aged 63 to 65 years, or pregnant.
Study conducted in only two geographic areas.
Conclusion:
A significant proportion of eligible patients opted for home screening, but further efforts are needed to enhance participation across diverse demographic groups.
