Wikström Ingrid, Stenvall Harriet, Wilander Erik
Department of Women's and Children's Health, Section for Obstetrics and Gynaecology, University Hospital of Uppsala, Sweden.
Acta Obstet Gynecol Scand. 2007;86(6):720-5. doi: 10.1080/00016340701303747.
The major problem with the cytological screening is the non-optimal participation rate among women invited for cervical smear collection. The aim of the present investigation was to examine the attitudes of the non-responding women to perform self-sampling of vaginal smear at home as a method to increase the coverage of the screening and to examine the prevalence of high-risk human papilloma virus (HPV) among the responding women.
From the database of the Department of Cytology, University Hospital of Uppsala 198 women, aged 35-55 years, who had not attended the organized gynaecological screening for over 6 years were identified. They were sent a letter of information about the study and one week later a self-sampling device aimed to collect vaginal smear. The vaginal smear of the women responding to the offer of self-sampling was analysed for high-risk HPV using Hybrid Capture 2 method or polymerase chain reaction amplification of HPV DNA. All women in the study also received a questionnaire in order to investigate their attitudes towards self-sampling as an alternative in the organized screening.
Of the 198 women 15 women had to be excluded. Fifty-eight per cent of the women responded and collected vaginal smear at home and among them 7% were positive for high-risk HPV. The questionnaire revealed no significant difference of age, country of birth and occupation or marital status, on using self-sampling of vaginal smear at home. The attitudes among responding and non-responding women differed. The responding women who contributed by sampling vaginal smear were more positive to self-sampling of vaginal smear (p<0.01).
Offering self-sampling of vaginal smear in women not attending the organized cytological screening increases the coverage and identifies an additional group of women with an increased risk to develop cervical cancer. The attitude towards self-sampling was mainly positive.
细胞学筛查的主要问题是受邀进行宫颈涂片采集的女性参与率不理想。本研究的目的是调查未回应者对在家自行采集阴道涂片作为增加筛查覆盖率方法的态度，并调查回应者中高危人乳头瘤病毒（HPV）的流行情况。
从乌普萨拉大学医院细胞学系的数据库中，识别出198名年龄在35 - 55岁之间、超过6年未参加过有组织的妇科筛查的女性。给她们发送了关于该研究的信息信，一周后发送了一个旨在采集阴道涂片的自行采样装置。对回应自行采样提议的女性的阴道涂片，使用杂交捕获2法或HPV DNA聚合酶链反应扩增法分析高危HPV。研究中的所有女性还收到了一份问卷，以调查她们对自行采样作为有组织筛查替代方法的态度。
198名女性中有15名被排除。58%的女性做出回应并在家中采集了阴道涂片，其中7%的高危HPV呈阳性。问卷显示，在年龄、出生国家、职业或婚姻状况方面，对于在家自行采集阴道涂片没有显著差异。回应者和未回应者的态度有所不同。通过采集阴道涂片做出贡献的回应女性对阴道涂片自行采样更为积极（p<0.01）。
为未参加有组织细胞学筛查的女性提供阴道涂片自行采样可提高覆盖率，并识别出另一组患宫颈癌风险增加的女性。对自行采样的态度总体上是积极的。
