Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA.
Prev Med. 2011 Jun;52(6):452-5. doi: 10.1016/j.ypmed.2011.03.018. Epub 2011 Apr 8.
The aim of the study was to increase participation in cervical cancer screening of under-screened women living in the Mississippi Delta, a U.S. population at high risk for cervical cancer.
We conducted a door-to-door feasibility study of women living in the Mississippi Delta to increase participation in cervical cancer screening in 2009-10. Women (n=119) aged 26-65 years who had not been screened in last 3 years or more, were not pregnant, and had a cervix were offered a cost-free choice: clinic-based Pap testing or home self-collection with HPV DNA testing.
Seventy-seven women (64.7%) chose self-collection with HPV testing, of which sixty-two (80.5%) returned their self-collected specimen. By comparison, 42 women (35.3%) chose Pap testing, of which 17 (40.5%) attended their clinic appointment. Thus there was an almost 4-fold greater participation of under-screened women in self-collection with HPV testing than in free Pap testing (78.4% vs. 21.5%).
We found that offering self-collection will increase participation in cervical cancer screening among under-screened populations living in the Mississippi Delta. Based on these preliminary results, we suggest that self-collection with HPV DNA testing might complement current Pap testing programs to reach under-screened populations of women, such as those living in the Mississippi Delta.
本研究旨在提高密西西比三角洲地区未接受过宫颈癌筛查的女性参与宫颈癌筛查的比例,该地区的人群具有较高的宫颈癌发病风险。
我们于 2009-2010 年在密西西比三角洲地区进行了一项针对女性的入户可行性研究,以提高宫颈癌筛查的参与率。纳入研究的女性年龄在 26-65 岁之间,且符合以下条件:过去 3 年以上未接受过筛查、未怀孕且具有宫颈。我们为其提供了免费的选择:诊所巴氏涂片检查或在家自行采集样本进行 HPV DNA 检测。
77 名女性(64.7%)选择了自行采集 HPV 检测样本,其中 62 名(80.5%)人返回了自行采集的样本。相比之下,42 名女性(35.3%)选择了巴氏涂片检查,其中 17 名(40.5%)人参加了诊所预约。因此,与巴氏涂片检查相比,未接受过筛查的女性更愿意选择自行采集 HPV 检测样本(78.4% vs. 21.5%)。
我们发现,提供自行采集样本的方式可以提高密西西比三角洲地区未接受过宫颈癌筛查的女性的参与率。基于这些初步结果,我们建议自行采集 HPV DNA 检测可能是巴氏涂片检查方案的补充,可以覆盖到未接受过筛查的女性人群,如密西西比三角洲地区的女性。