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All total of 35,354 women who did not participate in the Flemish cancer screening program were included in the study: 9,118 received a HPV self\u2010collection brush (RIATOL qPCR HPV genotyping test (qPCR [E6\/E7]); 9,098 were offered the opportunity to order an HPV\u2010selfsampling brush, 8,830 received the recall letter; 8,849 received no intervention. Within 12 months after the mailing, 18.7% of the women who had received the brush, participated by returning a self\u2010sample sample, while 10.6% women allocated to the opt\u2010 in group did so. 10.5% women who received the standard recall letter, had a PAP smear taken within a period of 12 months; while 8% women did so without receiving an intervention at all. Participation in postmenopausal women was higher than in women younger than 50 in both self\u2010sampling arms. Screening by means of the self\u2010sample kit increased by age, contradictory when screening is performed by a PAP smear. Of those testing hrHPV positive (9.5%), 88.9% attended for follow up cytology. The mean DNA concentration, found in the self\u2010sampler, decreased by age, causing a higher number of inconclusive results. Our results support the efficacy of a self\u2010sampling strategy to increase participation in the Flemish screening program. Self\u2010sampling seems particularly acceptable to postmenopausal non\u2010responders. Future research should focus on the performance of different self\u2010sampling devices in post\u2010menopausal women as low DNA concentrations exponentially increased over age.<\/jats:p>","DOI":"10.1002\/ijc.31391","type":"journal-article","created":{"date-parts":[[2018,3,23]],"date-time":"2018-03-23T10:48:28Z","timestamp":1521802108000},"page":"861-868","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["A randomized, controlled trial of two strategies of offering the home\u2010based HPV self\u2010sampling test to non\u2010 participants in the Flemish cervical cancer screening program"],"prefix":"10.1002","volume":"143","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4607-8121","authenticated-orcid":false,"given":"Eliane","family":"Kellen","sequence":"first","affiliation":[{"name":"Centre for Cancer Detection Flanders Belgium"},{"name":"University Hospital Leuven, Campus St. Rafael Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ina","family":"Benoy","sequence":"additional","affiliation":[{"name":"AML, Sonic Healthcare Antwerp Belgium"},{"name":"National Reference Centre for HPV Brussels Belgium"},{"name":"AMBIOR, Laboratory for Cell Biology &amp; 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