Abstract PR03: Clinic-based Pap test versus HPV home test among Somali immigrant women in Minnesota: A randomized controlled trail
Authors: Sewali Barrett P. , Askhir Asli , Belinson Jerome , Vogel Rachel I. , Okuyemi Kolawole S. , Joseph Anne , Ghebre Rahel G. 
Published: October 2015

Objective: It is unknown whether the Somali immigrant population in the United States may use the home-based HPV DNA self-collection as an acceptable method to cervical cancer screening. We aimed to determine the proportions of successful completion of cervical cancer screening using home collection kit versus clinic based Pap test.

Methods: We conducted a randomized controlled pilot study among Somali women in the Minneapolis and St. Paul metro area in Minnesota. Participants were randomly assigned in a 1:1 ratio to either the standard of care clinic based Pap test group or the home based HPV test group. Univariate and multivariate logistic regression models were conducted to explore factors associated with test completion.

Results: A total of 63 Somali women, were included in the final analysis. The mean age was 55 years and majority were married, 41% had no formal education, primarily spoke Somali, with an annual household income ≤ $25,000. Using intention to treat analysis, the odds of those assigned to the home group to complete the HPV test were 6.8 times more likely than those is the pap group within 3 months of study entry (Odds Ratio (OR)=6.82; 95% Confidence Interval (CI): 2.24-20.71) p = 0.0002). After adjusting for other potential confounders, women randomized to the home based HPV group were about 14 times more likely to complete screening than those assigned to the clinic based Pap group (OR: 14.18 [95% CI: 2.73-73.51], p=0.002). In addition, women who reported having friends/family members to talk with about cancer screening were approximately 3 times more likely to complete screening than those who do not, though this was not statistically significant after multivariate adjustment (OR: 3.14 [0.72-13.67], p=0.127). Finally, women who have lived in the US longer were more likely to complete screening remained statistically significant after adjustment (OR per 1 year longer: 1.23 [1.05-1.44], p=0.011).

Conclusions: Our study highlights several important factors that potentially could improve cervical cancer screening among Somali immigrant women in Minnesota. The use of a self-sampling HPV kit has the potential to increase screening in this community, as it potentially addresses some major sociocultural barriers such as; lack of privacy created by the need for an interpreter during a clinic based Pap test. Future research should explore the potential of using the home based HPV test kits as an initial approach to encourage use of cervical cancer screening in the Somali community.

This abstract was also presented as Poster B65.

Citation Format: Barrett P. Sewali, Asli Askhir, Jerome Belinson, Rachel I. Vogel, Kolawole S. Okuyemi, Anne Joseph, Rahel G. Ghebre. Clinic-based Pap test versus HPV home test among Somali immigrant women in Minnesota: A randomized controlled trail. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr PR03.