De Alba Israel, Anton-Culver Hoda, Hubbell F Allan, Ziogas Argyrios, Hess James R, Bracho America, Arias Caleb, Manetta Alberto
Department of Medicine, School of Medicine, University of California-Irvine, Irvine, California, USA.
Cancer Epidemiol Biomarkers Prev. 2008 Aug;17(8):2163-8. doi: 10.1158/1055-9965.EPI-07-2935.
The aim of the study was (a) to assess sensitivity and specificity of self-sampling in a community setting for identifying high-risk human papillomavirus (HPV) infection and abnormal Papanicolaou (Pap) smears and (b) to assess satisfaction with this collection method among Hispanic women.
Lay health workers distributed self-collection kits to Hispanic women in the community. Participants collected an unsupervised vaginal sample at home or in the place and time of their preference.
A total of 1,213 Hispanics were included and provided a self-sample for HPV testing and were invited for a Pap smear; 662 (55%) of them had a Pap smear and the first 386 of these also had a physician-collected sample for HPV retesting. Using physician collection as the gold standard, unsupervised self-collection had a sensitivity of 90% and specificity of 88% for identifying high-risk HPV. Compared with physician sampling, self-sampling in a community setting had comparable sensitivity for identifying a low-grade lesions or greater in the Pap smear (50% versus 55%; P = 0.45) but lower specificity (94% versus 79%). Overall experience with self-sampling was reported as excellent or very good by 64% and only 2.6% reported a poor or fair experience.
Unsupervised self-collection of vaginal samples for HPV testing in a community setting has a high sensitivity for identifying high-risk HPV and a high satisfaction among Hispanics. This approach may benefit populations with limited access to health care or with cultural barriers to cervical cancer screening.
本研究的目的是：（a）评估在社区环境中自我采样用于识别高危人乳头瘤病毒（HPV）感染和异常巴氏涂片的敏感性和特异性；（b）评估西班牙裔女性对这种采集方法的满意度。
非专业卫生工作者向社区中的西班牙裔女性分发自我采集试剂盒。参与者在自己选择的家中、地点和时间自行采集阴道样本，无需监督。
共纳入1213名西班牙裔女性，她们提供了用于HPV检测的自我样本，并被邀请进行巴氏涂片检查；其中662人（55%）进行了巴氏涂片检查，其中前386人还提供了由医生采集的样本用于HPV复测。以医生采集作为金标准，无监督的自我采集识别高危HPV的敏感性为90%，特异性为88%。与医生采样相比，在社区环境中自我采样识别巴氏涂片中低度及以上病变的敏感性相当（50%对55%；P = 0.45），但特异性较低（94%对79%）。64%的人报告自我采样的总体体验为优秀或非常好，只有2.6%的人报告体验较差或一般。
在社区环境中无监督地自行采集阴道样本进行HPV检测，对于识别高危HPV具有较高的敏感性，且西班牙裔女性的满意度较高。这种方法可能有益于获得医疗保健机会有限或在宫颈癌筛查方面存在文化障碍的人群。
