Snyman Leon C, Dreyer Greta, Botha Matthys H, van der Merwe Frederick Haynes, Becker Piet J
Department of Obstetrics and Gynaecology and Gynaecological Oncology Unit, Faculty of Health Sciences, University of Pretoria, South Africa.
S Afr Med J. 2015 Jan 6;105(2):115-20. doi: 10.7196/samj.8418.
Cervical cancer is preventable, but still highly prevalent in South Africa (SA). Screening strategies in the country have been ineffective, and new ways to prevent the disease are needed.
To investigate the feasibility of linking cervical cancer screening in adult women to human papillomavirus (HPV) vaccination in schoolgirls.
Ten primary schools in the South-West District of Tshwane, Gauteng Province, SA, took part in the study. Cervical cancer and HPV vaccine information was provided to schoolgirls and their parents. Consented schoolgirls were vaccinated and their female parents were invited to participate in self-screening.
Among 1 654 girls invited for vaccination, the consented and invited uptake rates were 99.4% and 64.0%, respectively. Vaccine completion rates were higher in schools where the vaccination programme was completed in the same calendar year than in those where it was administered over two calendar years. Of 569 adult females invited, 253 (44.5%) returned screen tests; 169 (66.8%) tested negative and 75 (29.6%) positive for any high-risk HPV (hrHPV). There were no differences in level of education, employment status or access to healthcare between women with positive and those with negative screen results.
Implementation of HPV vaccination in a primary school-based programme was successful, with high vaccine uptake and completion rates. Self-screening reached the ideal target group, and it is possible to link cervical cancer screening to the cervical cancer vaccine by giving women the opportunity of self-sampling for hrHPV testing. This is a novel and feasible approach that would require some adaptive strategies.
宫颈癌是可预防的，但在南非（SA）仍然高度流行。该国的筛查策略一直无效，需要新的疾病预防方法。
调查将成年女性宫颈癌筛查与女学生人乳头瘤病毒（HPV）疫苗接种相联系的可行性。
南非豪登省茨瓦内西南区的10所小学参与了该研究。向女学生及其家长提供了宫颈癌和HPV疫苗信息。同意接种的女学生接种了疫苗，并邀请她们的女性家长参与自我筛查。
在1654名受邀接种疫苗的女孩中，同意接种率和受邀接种率分别为99.4%和64.0%。在同一年完成疫苗接种计划的学校中，疫苗完成率高于分两个日历年进行接种的学校。在569名受邀的成年女性中，253人（44.5%）返回了筛查检测结果；169人（66.8%）高危型HPV（hrHPV）检测呈阴性，75人（29.6%）呈阳性。筛查结果为阳性和阴性的女性在教育水平、就业状况或获得医疗保健方面没有差异。
在以小学为基础的项目中实施HPV疫苗接种是成功的，疫苗接种率和完成率很高。自我筛查覆盖了理想的目标群体，通过让女性有机会自行采集样本进行hrHPV检测，有可能将宫颈癌筛查与宫颈癌疫苗联系起来。这是一种新颖且可行的方法，需要一些适应性策略。
