Rosenbaum Alan J, Gage Julia C, Alfaro Karla M, Ditzian Lauren R, Maza Mauricio, Scarinci Isabel C, Felix Juan C, Castle Philip E, Villalta Sofia, Miranda Esmeralda, Cremer Miriam L
Department of Obstetrics and Gynecology, University of Pittsburgh School of Medicine, Pittsburgh, USA; Fulbright US Student Program, US Department of State, WA, USA.
Department of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, USA.
Int J Gynaecol Obstet. 2014 Aug;126(2):156-60. doi: 10.1016/j.ijgo.2014.02.026. Epub 2014 May 2.
To determine the acceptability of self-collected versus provider-collected sampling among women participating in public sector HPV-based cervical cancer screening in El Salvador.
Two thousand women aged 30-49 years underwent self-collected and provider-collected sampling with careHPV between October 2012 and March 2013 (Qiagen, Gaithersburg, MD, USA). After sample collection, a random sample of women (n=518) were asked about their experience. Participants were questioned regarding sampling method preference, previous cervical cancer screening, HPV and cervical cancer knowledge, HPV risk factors, and demographic information.
All 518 women approached to participate in this questionnaire study agreed and were enrolled, 27.8% (142 of 511 responding) of whom had not received cervical cancer screening within the past 3 years and were considered under-screened. Overall, 38.8% (n=201) preferred self-collection and 31.9% (n=165) preferred provider collection. Self-collection preference was associated with prior tubal ligation, HPV knowledge, future self-sampling preference, and future home-screening preference (P<0.05). Reasons for self-collection preference included privacy/embarrassment, ease, and less pain; reasons cited for provider-collection preference were result accuracy and provider knowledge/experience.
Self-sampling was found to be acceptable, therefore screening programs could consider offering this option either in the clinic or at home. Self-sampling at home may increase coverage in low-resource countries and reduce the burden that screening places upon clinical infrastructure.
确定在萨尔瓦多参与公共部门基于人乳头瘤病毒(HPV)的宫颈癌筛查的女性中,自我采集样本与医护人员采集样本的可接受性。
2012年10月至2013年3月期间,2000名30 - 49岁的女性使用careHPV(美国马里兰州盖瑟斯堡的Qiagen公司产品)进行了自我采集样本和医护人员采集样本。样本采集后,随机抽取了一部分女性(n = 518)询问她们的经历。参与者被问及样本采集方法偏好、既往宫颈癌筛查情况、HPV和宫颈癌知识、HPV风险因素以及人口统计学信息。
所有518名被邀请参与该问卷调查研究的女性均同意并被纳入,其中27.8%(511名有回应者中的142名)在过去3年内未接受过宫颈癌筛查,被视为筛查不足。总体而言,38.8%(n = 201)的女性更喜欢自我采集,31.9%(n = 165)的女性更喜欢医护人员采集。自我采集偏好与既往输卵管结扎、HPV知识、未来自我采样偏好以及未来家庭筛查偏好相关(P < 0.05)。自我采集偏好的原因包括隐私/尴尬、方便以及疼痛较轻;医护人员采集偏好的原因是结果准确性和医护人员的知识/经验。
自我采样被认为是可接受的,因此筛查项目可以考虑在诊所或家中提供这种选择。在资源匮乏的国家,在家中进行自我采样可能会提高筛查覆盖率,并减轻筛查对临床基础设施造成的负担。