Wong Eliza L Y, Cheung Annie W L, Huang Fenwei, Chor Josette S Y
Author Affiliations: The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
Cancer Nurs. 2018 Jan/Feb;41(1):45-52. doi: 10.1097/NCC.0000000000000462.
The causal relation between human papillomavirus (HPV) and cervical cancer has enabled HPV self-sampling to be envisaged as a possible screening method.
The aim of this study is to explore the acceptability and reliability of HPV DNA self-sampling as an alternative option for cervical screening among female sex workers.
Sixty-eight participants carried out self-sampling for HPV testing, gave a clinician-obtained sample for HPV testing, and a Papanicolaou test. After the samplings, the participants were questioned on the acceptability of the tests.
Most participants (65.6%) preferred to adopt HPV DNA self-sampling in the future; in particular, those without previous experience of Papanicolaou tests marginally significantly preferred self-sampling (86.7%, P = .055). The overall crude agreement in HPV detection rates between clinician and HPV DNA self-sampling was 85.3% (58/68), with a κ of 0.69 (95% confidence interval, 0.51-0.87). The sensitivity and specificity of self-collected samples were 66.7% and 66.1%, respectively, and the positive and negative predicted values were 24.0% and 92.5%, respectively. The prevalence of HPV was slightly higher in self-collected samples (39.7%, 27/68) than in clinician-collected samples (36.8%, 25/68). The participants expressed positive attitudes toward self-sampling but were less confident in their skills of self-sampling compared with clinicians (70.6% versus 91.2%).
The findings showed that self-sampling could be incorporated into current cervical cancer screening approaches.
Self-sampling could potentially increase compliance to cervical cancer screening and thus reduce the morbidity and mortality from cervical cancer. Further research and education on self-sampling will be required for women of diverse backgrounds.
人乳头瘤病毒（HPV）与宫颈癌之间的因果关系使得HPV自我采样被设想为一种可能的筛查方法。
本研究旨在探讨HPV DNA自我采样作为女性性工作者宫颈癌筛查替代方案的可接受性和可靠性。
68名参与者进行了HPV检测的自我采样，提供了临床医生采集的样本用于HPV检测，以及进行了巴氏试验。采样后，对参与者进行了关于检测可接受性的询问。
大多数参与者（65.6%）表示未来更倾向于采用HPV DNA自我采样；特别是那些以前没有巴氏试验经验的参与者略微更倾向于自我采样（86.7%，P = 0.055）。临床医生采集样本与HPV DNA自我采样之间HPV检测率的总体粗一致性为85.3%（58/68），κ值为0.69（95%置信区间，0.51 - 0.87）。自我采集样本的敏感性和特异性分别为66.7%和66.1%，阳性预测值和阴性预测值分别为24.0%和92.5%。自我采集样本中HPV的流行率（39.7%，27/68）略高于临床医生采集的样本（36.8%，25/68）。参与者对自我采样表达了积极态度，但与临床医生相比，她们对自我采样技能的信心较低（70.6%对91.2%）。
研究结果表明自我采样可以纳入当前的宫颈癌筛查方法。
自我采样可能会提高宫颈癌筛查的依从性，从而降低宫颈癌的发病率和死亡率。对于不同背景的女性，需要进一步开展关于自我采样的研究和教育。
