Karjalainen Liisa, Anttila Ahti, Nieminen Pekka, Luostarinen Tapio, Virtanen Anni
Mass Screening Registry, Finnish Cancer Registry, Unioninkatu 22, FI-00130, Helsinki, Finland.
Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, Jorvi Hospital, Turuntie 150, Espoo, Finland.
BMC Cancer. 2016 Mar 15;16:221. doi: 10.1186/s12885-016-2246-9.
High coverage and attendance is essential for cervical cancer screening success. We investigated whether the previous positive experiences on increasing screening attendance by self-sampling in Finland are sampler device dependent.
All women identified to cervical cancer screening in 2013 in 28 Finnish municipalities were randomised to receive a lavage- (n = 6030) or a brush type of self-sampling device (n = 6045) in case of non-attendance after two invitation letters. Seven hundred seventy non-attending women in the lavage device group and 734 in the brush group received the self-sampling offer. Women's experiences were enquired with an enclosed questionnaire.
Total attendance in the lavage group increased from 71.0 to 77.7% by reminder letters and further to 80.5% by self-sampling. Respective increase in the brush group was from 72.2 to 78.6% and then to 81.5%. The participation by self-sampling was 21.7% (95% CI 18.8-24.6) in the lavage group and 23.8% (95% CI 20.8-26.9) in the brush group. Women's self-sampling experiences were mainly positive and the sampler devices were equally well accepted by the women.
Our study shows that the lavage device and brush device perform similarly in terms of uptake by non-attending women and user comfort. If self-sampling is integrated to the routine screening program in Finland, either of the devices can be chosen without the fear of losing participants due to a less acceptable device.
高覆盖率和高参与率是宫颈癌筛查成功的关键。我们调查了芬兰以往通过自我采样提高筛查参与率的积极经验是否依赖于采样设备。
2013年在芬兰28个城市被确定需进行宫颈癌筛查的所有女性，在收到两封邀请信后仍未参加筛查的情况下，被随机分配接受灌洗式采样设备（n = 6030）或刷式自我采样设备（n = 6045）。灌洗式采样设备组的770名未参加筛查的女性和刷式采样设备组的734名未参加筛查的女性收到了自我采样邀请。通过随附的问卷询问女性的体验。
灌洗式采样设备组通过提醒信，总参与率从71.0%提高到77.7%，通过自我采样进一步提高到80.5%。刷式采样设备组的相应提高分别为从72.2%到78.6%，然后到81.5%。灌洗式采样设备组自我采样的参与率为21.7%（95%置信区间18.8 - 24.6），刷式采样设备组为23.8%（95%置信区间20.8 - 26.9）。女性的自我采样体验主要是积极的，两种采样设备被女性接受的程度相同。
我们的研究表明，灌洗式采样设备和刷式采样设备在未参加筛查女性的接受度和用户舒适度方面表现相似。如果将自我采样纳入芬兰的常规筛查计划，可以选择任何一种设备，不用担心因设备接受度较低而导致参与者流失。
