Stenvall Harriet, Wikström Ingrid, Wilander Erik
Department of Genetics and Pathology, University Hospital of Uppsala, Uppsala, Sweden.
Acta Derm Venereol. 2007;87(3):243-5. doi: 10.2340/00015555-0205.
Since the introduction of organized cytological screening in Sweden, most women currently presenting with cervical cancer are those who have not attended the programme and who have no cytological screening history. The aims of this study were: (i) to measure the response rate among women not attending organized cytological screening who were offered a device for self-sampling a vaginal smear at home; (ii) to examine the prevalence of high-risk human papilloma virus (HPV) among women performing self-sampling. Women aged 35-50 years, who had not participated in organized cytological screening for more than 6 years, were offered the opportunity to collect vaginal samples at home using a self-sampling device (Qvintip). The material collected was analysed for high-risk HPV using the Hybrid Capture 2 method. Of 369 women included in the study, 179 (49%) ordered the self-sampling device and 117 (32%) performed self-sampling at home and sent the sample to our laboratory for analysis. The mean prevalence of high-risk HPV was 26% (30/117), 31% (25/80) in women aged 35-42 years and 14% (5/37) in women aged 43-50 years. There was no significant difference in the participation rate with regard to age. The prevalence of high-risk HPV in women not covered by organized screening was considerably higher than in the general population; therefore they may represent a category at high risk of cervical cancer. The study shows that the use of a disposable self-sampling device for HPV testing is a relevant method to increase the participation rate in countries with organized cytological screening.
自从瑞典引入有组织的细胞学筛查以来，目前大多数宫颈癌患者是那些未参加该计划且没有细胞学筛查史的女性。本研究的目的是：（i）测量未参加有组织细胞学筛查的女性中，那些被提供在家自行采集阴道涂片装置的女性的响应率；（ii）检查自行采样女性中高危人乳头瘤病毒（HPV）的流行情况。年龄在35 - 50岁、超过6年未参加有组织细胞学筛查的女性，有机会使用自行采样装置（Qvintip）在家采集阴道样本。使用杂交捕获2法对采集的样本进行高危HPV分析。在纳入研究的369名女性中，179名（49%）订购了自行采样装置，117名（32%）在家进行了自行采样并将样本送至我们实验室进行分析。高危HPV的平均流行率为26%（30/117），35 - 42岁女性中为31%（25/80），43 - 50岁女性中为14%（5/37）。参与率在年龄方面没有显著差异。未被有组织筛查覆盖的女性中高危HPV的流行率明显高于一般人群；因此她们可能代表宫颈癌的高危类别。该研究表明，在有组织细胞学筛查的国家，使用一次性自行采样装置进行HPV检测是提高参与率的一种相关方法。
