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Acceptability and response to a postal survey using self-taken samples for HPV vaccine impact monitoring
  1. Katy Sinka1,
  2. Michelle Lacey1,
  3. Chris Robertson2,
  4. Kim Kavanagh2,
  5. Kate Cuschieri3,
  6. Donna Nicholson4,
  7. Martin Donaghy1
  1. 1Immunisation, NSS Health Protection Scotland, Glasgow, UK
  2. 2Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
  3. 3Scottish HPV reference Laboratory, Department of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK
  4. 4Epidemiology and Statistics Group, NSS Information Services Division, Paisley, UK
  1. Correspondence to Dr Katy Sinka, NSS Health Protection Scotland, Meridian Court, 5 Cadogan Street, G2 6QE Glasgow, UK; k.sinka{at}


Objective To assess the feasibility and acceptance of a postal survey to measure human papillomavirus (HPV) prevalence and monitor vaccine impact, using self-taken specimens from young women who do not attend their first cervical screening appointment.

Methods Focus groups informed the survey design identifying factors that would influence acceptability. Postal testing kits were sent to a nationally representative sample of unscreened women. Overall response rate, the influence of different specimen types (urine or vaginal swab) and the receipt of a reminder letter on participation were calculated. Specimens were tested anonymously for HPV. Individual test results were not provided.

Results Of 5500 kits sent, 725 were returned (13.2%). Fifty-two women actively opted out. There was a higher return rate for urine kits (13.7% vs 12%) and from those who received a reminder letter (15.5% vs 12.2%). Response was influenced by deprivation (10.3% in the most deprived quintile vs 16.2% in the least). Overall weighted HPV prevalence was 35.9% (40.0% from swab specimens and 31.9% from urine).

Conclusions Some women were willing to participate in anonymised postal testing. However, the low uptake means that HPV prevalence results are difficult to interpret for ongoing surveillance. Monitoring HPV vaccine impact outwith the cervical screening programme remains challenging.

  • HPV vaccines
  • prevalence study
  • epidemiology
  • surveillance methods
  • vaccination
  • epidemiology (general)
  • surveillance
  • HPV
  • adolescent
  • cervical cytology
  • communication skills
  • cervical cancer
  • virology
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  • Funding This work was supported by Scottish Government Health Directorate.

  • Competing interests None.

  • Ethics approval The study was given ethics approval by West Glasgow Ethics Committee (09/S0703/13).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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