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

## TL;DR

This study tests the feasibility of using at-home urine samples to screen older UK women for HPV, aiming to reduce cervical cancer deaths in those who missed earlier screenings.

## Contribution

The study introduces a feasible catch-up HPV screening method using first-void urine samples for older women in the UK.

## Key findings

- 59% of invited women aged 60–79 returned a urine sample for HPV testing.
- Telephone reminders increased response rates by 5% compared to text messages.
- 39% of women who previously declined NHS screening participated in the catch-up program.

## Abstract

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.

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.

GP practices in Hull and Manchester, UK.

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

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

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

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).

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.