That's one of the things we've debated in discussing how to a create a program and whether you create an opt-in program or an opt-out program.
As you can imagine, an opt-out program would be incredibly expensive. That would involve mailing a self-testing kit to every person who was available and then seeing who mailed it back. I don't know, from a cost analysis standpoint, whether that would actually work out.
I think if you were going for something like an HPV self-testing program, you'd have to go for letters of introduction, followed by an opt-in, and then send a test to someone who requested it. You would then be more likely to actually get that test back and be able to do that screening.
Definitely health costs are a huge consideration for those types of programs.