Department of Obstetrics & Gynecology, Columbia University Medical Center, New York, New York, USA.
J Womens Health (Larchmt). 2012 Dec;21(12):1275-81. doi: 10.1089/jwh.2012.3512. Epub 2012 Aug 20.
A simpler approach to cervical cancer screening could increase coverage, thus reducing cervical cancer mortality in the United States. Self-collection of specimens for screening tests may be one such approach. The aim of this study was to assess the acceptability of a self-lavaging device (Delphi Screener(™), Scherpenzeel, The Netherlands) for cervical cancer screening. Self-lavage specimens have been shown to have equivalent sensitivity for detection of high-grade cervical intraepithelial neoplasia (CIN) when coupled with high-risk human papillomavirus (HPV) tests as clinician-collected specimens with cytologic review.
Low-income women (n=198) who had recently received cervical cytologic testing in one of three participating clinics in New York City enrolled; 197 self-lavaged. Women answered open-ended and closed-ended questions on ease of use, level of comfort with the self-lavage and the pelvic examination, and future screening preference.
Ninety-six percent of women reported they were very/somewhat comfortable self-lavaging compared to 47% very/somewhat comfortable with the clinician collecting a specimen during a pelvic examination (p<0.001). The majority (79%) would prefer self-lavage the next time they need to be screened; only 8% would prefer pelvic examination by a doctor, and 14% had no preference. The main reasons for preferring self-lavage centered on convenience and comfort.
Self-lavaging was highly acceptable to women in this study. Self-collection of specimens has the potential to simplify screening and reduce logistical barriers for many women, which could increase overall coverage of cervical cancer screening.
采用更简单的宫颈癌筛查方法可以提高覆盖率，从而降低美国的宫颈癌死亡率。自我采集标本进行筛查可能是一种方法。本研究旨在评估一种自我冲洗设备（Delphi Screener(™)，荷兰舍彭泽尔）用于宫颈癌筛查的可接受性。自我冲洗标本与高危型人乳头瘤病毒（HPV）检测联合应用时，与临床医生采集标本并进行细胞学检查相比，其检测高级别宫颈上皮内瘤变（CIN）的敏感性相当。
最近在纽约市的三个参与诊所之一接受宫颈细胞学检查的低收入妇女（n=198）入组；197 名自我冲洗。女性回答了关于使用方便性、自我冲洗和盆腔检查舒适度以及未来筛查偏好的开放式和封闭式问题。
96%的女性报告说与临床医生采集标本进行盆腔检查时（p<0.001）相比，她们非常/有些舒适地自我冲洗。大多数（79%）下次需要筛查时会选择自我冲洗；只有 8%会选择医生进行盆腔检查，14%没有偏好。选择自我冲洗的主要原因是方便和舒适。
在这项研究中，自我冲洗受到女性的高度认可。自我采集标本有可能简化筛查，并减少许多女性的后勤障碍，从而提高宫颈癌筛查的总体覆盖率。
