The Use of First‐Void Urine to Screen Women Aged 60–79 for HPV in the UK: The Catch‐Up Screen Study

ABSTRACT

Objective

Almost half the deaths from cervical cancer in the UK are among women aged over 65 who were already above the upper age of screening when primary HPV screening was introduced in the UK in 2019. Our aim is to test the feasibility of a national catch‐up HPV testing programme.

Design

This first phase of the Catch‐Up Screen study involved randomizing over 3000 invited participants to receive a urine HPV test and a follow‐up telephone call or text message.

Setting

GP practices in Hull and Manchester, UK.

Population

Women aged 60–79 who have not undergone primary HPV screening.

Methods

Eligible women were selected from GP practice records, and 3074 were invited to provide an at‐home first‐void urine sample for HPV testing.

Main Outcome Measures

Uptake of at‐home urine screening according to screening history, area‐level index of deprivation, and randomised follow‐up method.

Results

Overall, 59% (1816) of invited women returned a urine sample for HPV testing. Response varied by screening history and index of area‐level deprivation, but 39% of those who declined their last invited NHS screen responded favorably and took part in Catch‐Up Screen. Telephone reminders yielded a 5% absolute increase in response compared to the text message arm ( p  = 0.007).

Conclusions

An at‐home first‐void urine sample is a viable method for a national catch‐up HPV test and has the potential to address decreasing national coverage among older women being invited for their last screen.