TOPLINE:

Mailing human papillomavirus (HPV) self-sampling kits to people due for cervical cancer screening was more cost effective than usual care, which included clinician electronic medical record alerts and mailed patient reminders or education material and opt-in approaches.

METHODOLOGY:

• The study included an analysis of data from a randomized clinical trial conducted over a 2-year period involving 31,355 people with an average age of 45.9 years; it examined the costs and financial effects of various screening programs.
• Researchers randomized participants aged 30-64 years into three groups based on screening history — adherent (41.4%), overdue (26.3%), and unknown (31.6%).
• The primary outcome was screening completion within 6 months after randomization; researchers evaluated the cost per additional screening completed for each approach.

TAKEAWAY:

• Among patients who were overdue for screening, direct mail of HPV kits showed costs ranging from -$19 (95% CI, -21 to -16) to $63 (95% CI, 39-87) per additional completed screen.
• The total per member per month program costs for each method overall was $16.73 for adherent members, $9.88 for overdue members, and $8.44 for members with unknown screening histories.
• While the screening adherent subgroup had the largest 1-year program budget for sending the self-sampling kits (roughly $1 million), their budget decreased to roughly $150,000 by year 4, the lowest among all subgroups.

IN PRACTICE:

“Our results support directly mailing HPV kits to eligible individuals as an effective, efficient, and affordable outreach strategy,” the study authors wrote.

SOURCE:

The study was led by Richard Meenan, PhD, MPH, MBA, of the Center for Health Research at Kaiser Permanente Northwest in Portland, Oregon. It was published online on October 1 in JAMA Network Open.

LIMITATIONS:

The trial was conducted in a single US health system where all patients had health insurance and a primary care clinician. It also took place during the COVID pandemic when in-person visits were limited.

DISCLOSURES:

Various study authors reported receiving grants from the National Cancer Institute; National Heart, Lung, and Blood Institute; CDC; and Patient-Centered Outcomes Research Institute outside the submitted work.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.