Under-screened women’s reactions to at-home self-collected human papillomavirus test result delivery

Abstract Background Mailed self-collection kits for high-risk human papillomavirus (HPV) detection can increase access to cervical cancer screening among under-screened women. To design effective screening programs, it is necessary to evaluate women’s understanding, reactions, and preferences for self-collected HPV test result delivery. Methods The My Body, My Test-3 trial assessed the effectiveness of mailed HPV self-collection kit outreach. Between 2016-2019, the trial enrolled low-income women aged 25-64 years in North Carolina overdue for cervical cancer screening. Our analytical sample included women from the intervention arm who conducted at-home self-collection, returned a self-collection kit, had a conclusive HPV result, and completed a follow-up survey after results were received by phone but before in-clinic screening. We evaluated women’s understanding, reactions, and preferences for result delivery, stratified by result positivity. Results Among 296 diverse, low-income women, 16% (n = 47/296) had an HPV-positive result and 84% (n = 249/296) had an HPV-negative result. Most women understood their results as an indicator of cervical cancer risk, and 93% (n = 264/284 who responded) correctly recalled their results one-week post-receipt. Women with a positive result more frequently reported feeling afraid and worried, and less frequently reported feeling relieved, compared to those with a negative result (all p < .001). Most women were comfortable receiving results by phone (HPV-positive result: 85%, n = 40/47; HPV-negative result: 96%, n = 238/249), although some with a positive result had remaining questions. Conclusions Although most women delivered their mailed, self-collected HPV result by phone understood their result, future United States screening programs should provide educational support during and after HPV-positive result delivery.