Nelson Erik J, Maynard Brandy R, Loux Travis, Fatla Jessica, Gordon Rebecca, Arnold Lauren D
Department of Epidemiology, College for Public Health and Social Justice, St Louis, Missouri, USA.
School of Social Work, College for Public Health and Social Justice, St Louis, Missouri, USA.
Sex Transm Infect. 2017 Feb;93(1):56-61. doi: 10.1136/sextrans-2016-052609. Epub 2016 Oct 19.
To examine whether or not self-sampled cervical screening for human papillomavirus (HPV) DNA is acceptable and if women prefer self-sampling to clinician-based sampling.
Systematic review and meta-analysis.
Thirty-seven primary studies obtained through a comprehensive search of six electronic bibliographic databases from 1986 to 2014 and other sources. Search keywords included HPV, screening, DNA testing, vaginal testing, self-collected specimen, self-collected sample, self-sampling, self-screening, preferences and acceptability.
Studies eligible for analysis included those that had participants perform self-sampling, evaluated participant acceptance of or preference for self-sampled vaginal HPV DNA and reported data to calculate an effect size. There were no exclusion criteria for publication status or geographical location. Meta-analytic methods were used to quantitatively synthesise effect sizes across studies.
The 37 studies included 18 516 female participants from 24 countries across five continents. Overall, there was a high level of acceptability of self-sampling among the participants. Participants reported preference for self-sampling over clinician sampling due to attractive characteristics such as ease and privacy.
The overall acceptability of self-sampled cervical screening, coupled with economic and effective care, provides opportunities for expanding screening services. Importantly, this can provide a creative screening alternative for women who do not participate in traditional cytological screening, and may ultimately reduce health disparities and prevent cervical disease.
探讨人乳头瘤病毒（HPV）DNA自我采样宫颈筛查是否可接受，以及女性是否更倾向于自我采样而非临床医生采样。
系统评价与荟萃分析。
通过全面检索1986年至2014年的六个电子文献数据库及其他来源获得的37项原始研究。检索关键词包括HPV、筛查、DNA检测、阴道检测、自我采集标本、自我采集样本、自我采样、自我筛查、偏好和可接受性。
符合分析条件的研究包括那些让参与者进行自我采样、评估参与者对自我采样阴道HPV DNA的接受程度或偏好并报告数据以计算效应量的研究。对发表状态或地理位置没有排除标准。采用荟萃分析方法对各项研究的效应量进行定量综合分析。
这37项研究包括来自五大洲24个国家的18516名女性参与者。总体而言，参与者对自我采样的接受程度较高。由于诸如简便和私密等吸引人的特点，参与者报告称比起临床医生采样，他们更倾向于自我采样。
自我采样宫颈筛查的总体可接受性，再加上经济有效的护理，为扩大筛查服务提供了机会。重要的是，这可以为未参与传统细胞学筛查的女性提供一种创新性的筛查选择，并最终可能减少健康差距和预防宫颈疾病。
