Brown L, Ritvo P, Howlett R, Cotterchio M, Matthew A, Rosen B, Murphy J, Mai V
Cancer Care Ontario, Toronto, Ontario, Canada.
Health Care Women Int. 2007 Oct;28(9):782-98. doi: 10.1080/07399330701563061.
As most women diagnosed with cervical carcinoma have been "inadequately screened," improvements in screening are critical. After abnormal Pap test findings (through liquid-based cytology), residual specimens now can be tested simultaneously for oncogenic types of Human Papilloma virus (HPV). If these "reflex" HPV tests are negative, Pap tests need not be repeated for 12 months. Women with positive oncogenic HPV tests, however, can be referred immediately for colposcopy. There has been concern that "stigma" issues could be associated with positive HPV status (because of its sexual transmission) that might cause women to avoid this reflex HPV testing. We addressed this concern by assessing whether stigma issues surface in relation to HPV testing. We randomly selected 20 women and administered to them semistructured telephone interviews that included responses to a scenario of reflex HPV-DNA testing. Interview transcripts were analyzed qualitatively. Highly limited knowledge levels were found about HPV, but, following education about screening options, there was no rejection of HPV testing. In conclusion, it appears that women favor reflex HPV testing due to its "convenience" and perceptions that it is "the least intrusive option more definitive than Pap testing."
由于大多数被诊断为宫颈癌的女性此前“筛查不足”，因此改进筛查至关重要。在巴氏试验出现异常结果后（通过液基细胞学检查），现在可以同时对剩余标本进行致癌型人乳头瘤病毒（HPV）检测。如果这些“补充”HPV检测结果为阴性，巴氏试验在12个月内无需重复进行。然而，致癌型HPV检测结果呈阳性的女性可立即转诊进行阴道镜检查。有人担心“污名化”问题可能与HPV阳性状态有关（因其通过性传播），这可能导致女性回避这种补充HPV检测。我们通过评估污名化问题是否会因HPV检测而出现来解决这一担忧。我们随机挑选了20名女性，对她们进行了半结构化电话访谈，其中包括对补充HPV-DNA检测情况的回答。对访谈记录进行了定性分析。发现她们对HPV的了解程度非常有限，但在接受关于筛查选项的教育后，她们并不排斥HPV检测。总之，女性似乎因HPV检测“方便”以及认为它“是比巴氏试验侵入性更小且更具确定性的选择”而倾向于接受补充HPV检测。
