Latiff Latiffah A, Rahman Sabariah Abdul, Wee Wong Yong, Dashti Sareh, Andi Asri Andi Anggeriana, Unit Nor Hafeeza, Siah Li Shirliey Foo, Esfehani Ali Jafarzadeh, Ahmad Salwana
Department of Community Health, Universiti Putra Malaysia, Selangor, Malaysia E-mail :
Asian Pac J Cancer Prev. 2015;16(2):559-64. doi: 10.7314/apjcp.2015.16.2.559.
The participation of women in cervical cancer screening in Malaysia is low. Self-sampling might be able to overcome this problem.The aim of this study was to assess the reliability of self-sampling for cervical smear in our country.
This cross-sectional study was conducted on 258 community dwelling women from urban and rural settings who participated in health campaigns. In order to reduce the sampling bias, half of the study population performed the self-sampling prior to the physician sampling while the other half performed the self-sampling after the physician sampling, randomly. Acquired samples were assessed for cytological changes as well as HPV DNA detection.
The mean age of the subjects was 40.4±11.3 years. The prevalence of abnormal cervical changes was 2.7%. High risk and low risk HPV genotypes were found in 4.0% and 2.7% of the subjects, respectively. A substantial agreement was observed between self-sampling and the physician obtained sampling in cytological diagnosis (k=0.62, 95%CI=0.50, 0.74), micro-organism detection (k=0.77, 95%CI=0.66, 0.88) and detection of hormonal status (k=0.75, 95%CI=0.65, 0.85) as well as detection of high risk (k=0.77, 95%CI=0.4, 0.98) and low risk (K=0.77, 95%CI=0.50, 0.92) HPV. Menopausal state was found to be related with 8.39 times more adequate cell specimens for cytology but 0.13 times less adequate cell specimens for virological assessment.
This study revealed that self-sampling has a good agreement with physician sampling in detecting HPV genotypes. Self-sampling can serve as a tool in HPV screening while it may be useful in detecting cytological abnormalities in Malaysia.
马来西亚女性参与宫颈癌筛查的比例较低。自我采样或许能够克服这一问题。本研究的目的是评估我国宫颈涂片自我采样的可靠性。
本横断面研究针对258名来自城乡社区、参与健康活动的女性开展。为减少采样偏倚，研究人群的一半在医生采样之前进行自我采样，另一半则随机在医生采样之后进行自我采样。对采集的样本进行细胞学变化评估以及人乳头瘤病毒（HPV）DNA检测。
受试者的平均年龄为40.4±11.3岁。宫颈异常变化的患病率为2.7%。分别在4.0%和2.7%的受试者中发现了高危和低危HPV基因型。在细胞学诊断（k=0.62，95%置信区间=0.50，0.74）、微生物检测（k=0.77，95%置信区间=0.66，0.88）、激素状态检测（k=0.75，95%置信区间=0.65，0.85）以及高危（k=0.77，95%置信区间=0.4，0.98）和低危（K=0.77，95%置信区间=0.50，0.92）HPV检测方面，自我采样与医生采样之间观察到高度一致性。发现绝经状态与用于细胞学检查的足够细胞样本多8.39倍相关，但与用于病毒学评估的足够细胞样本少0.13倍相关。
本研究表明，在检测HPV基因型方面，自我采样与医生采样具有良好的一致性。自我采样可作为HPV筛查的一种工具，同时在马来西亚检测细胞学异常方面可能有用。
