Abstract B040: Self-sampling for HPV DNA testing increases participation in cervical cancer screening among Asian American women

Abstract Background: Clinic-based Pap and human papillomavirus (HPV) testing has led to significant reductions in cervical cancer; however, screening rates are suboptimal among Asian American women. Low participation in clinic-based cervical cancer screening is due in part to psychosocial (e.g., embarrassment) and access factors (e.g., lack of transportation, limited English proficiency), which have been difficult to address with traditional screening interventions. Self-collection of a vaginal sample for HPV testing may offer a viable approach for overcoming these challenges. In a large-scale randomized trial, we examined the effects of a community-engaged intervention on facilitating uptake of self-collected cervicovaginal samples for HPV DNA testing. Methods: In this randomized controlled study, we enrolled 1,140 Asian American women (ages 30-65 years) who were not up to date with recommended cervical cancer screening guidelines. Participants were randomized to receive either a community educational workshop on cervical cancer including referrals to sites with free or low-cost Pap test screening (control condition, n=588), or the same workshop plus an HPV self-sampling kit (intervention condition, n=552). The kit included an FDA-approved device (brush) for the self-collection of cervicovaginal samples, along with detailed instructions on how to collect a sample and return it to study staff. All materials were available in English, Korean, Vietnamese and Chinese languages. Results: Participants were on average 52.5 years of age (SD=9.2 years) and predominantly foreign-born (99.8%). More than 55% of study participants had a high school education or less, and 47% had never had a Pap test. At 6-months post-workshop, we assessed the proportion of participants who completed cervical cancer screening (either received a Pap test or returned a sample for HPV testing). The majority of participants in the intervention condition (87%) returned a self-collected sample for HPV testing, whereas only 30% of participants in the control condition obtained a clinic-based Pap or HPV test. Among women who completed HPV self-sampling, nearly 10% tested positive for high-risk HPV (hrHPV), with an additional 5% testing positive for low- or intermediate-risk HPV strains. All women who tested positive for hrHPV received navigation assistance to follow up care. Conclusion: Although some clinic-based cancer screening interventions can successfully reach underscreened women, various factors such as limited clinic hours, inconvenient locations, and transportation challenges continue to hinder access and screening uptake for many women. This study demonstrates that self-sampling for HPV testing can be a successful strategy for enhancing participation in cervical cancer screening among Asian American women and offers a pragmatic approach for increasing scalability across all populations living in under-resourced communities and regions. Citation Format: Carolyn Y. Fang, Phuong T. Do, Wenyue Lu, Ellen J. Kim, Xiaofang Zhou, Brian L. Egleston, Minzi Li, Yuku Chen, Lin zhu, Yin Tan, MinQi Wang, Sara Kim, Jae Chung, Grace X. Ma. Self-sampling for HPV DNA testing increases participation in cervical cancer screening among Asian American women abstract. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B040.