Abstract B025: Follow up after a positive HPV test result: Results from the PRESTIS study

Abstract Background: HPV self-collection was recently FDA-approved for cervical cancer screening. In the PRESTIS trial, we recently demonstrated a 2.5-fold increase in screening participation among underscreened women in a public safety net health system who received a mailed at-home HPV self- collection kit compared to those who received a standard telephone reminder. However, receipt of clinical follow up among participants with a positive HPV test has not been described. Methods: We used data from the PRESTIS randomized clinical trial (n=2,464). Bilingual (English/Spanish) patient navigation was provided to assist participants with a positive HPV test result with scheduling and attending follow up appointments (colposcopy if positive for HPV 16 or 18; triage Pap test if positive for other high-risk types). We summarized receipt of follow-up care in regard to timeliness and demographic characteristics using descriptive and bivariable statistics. Results: Among participants with a positive HPV test result (n=90), 83.3% scheduled a follow up test and 70.0% completed clinical follow up. Among those who attended follow up (n=63), 65.1% received timely follow up within 3 months of their test result; 15.9% and 19.1%, respectively, received follow up between 3-6 months and after 6 months of their test result. Patients who needed colposcopy (n=16) had a higher proportion of follow up (93.8%) compared to those triaged to Pap testing (64.9% of n= 74). Fewer non-Hispanic Black participants (58.6%) attended clinical follow up compared to Hispanic (76.4%) and non-Hispanic White (66.7%) participants. A higher proportion of those with county-funded financial assistance (75.5%) and commercial insurance (65.2%) attended follow up compared with those covered by Medicaid, Medicare, or other insurance plans (53.9%). Conclusions: While mailed self-collection kits can increase cervical screening participation, almost one-third of participants with a positive HPV test did not complete clinical follow-up, despite patient navigation. This underscores the need for additional strategies to address barriers among screen-positive patients to ensure they receive timely and appropriate follow-up care. Citation Format: Graciela Nogueras, Trisha Amboree, Susan Parker, Antonia Marinoni, Matthew Anderson, Susan Hilsenbeck, Shaun Bulsara, Maria Daheri, Maria Jibaja-Weiss, Kathleen Schmeler, Ashish Deshmukh, Elizabeth Chiao, Michael Scheurer, Jane Montealegre. Follow up after a positive HPV test result: Results from the PRESTIS study [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B025.