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用于宫颈癌筛查的自我采集人乳头瘤病毒检测的临床医生和患者可接受性

Clinician and Patient Acceptability of Self-Collected Human Papillomavirus Testing for Cervical Cancer Screening.

作者信息

Mao Constance, Kulasingam Shalini L, Whitham Hilary K, Hawes Stephen E, Lin John, Kiviat Nancy B

机构信息

1 Department of Obstetrics and Gynecology, University of Washington School of Medicine , Seattle, Washington.

2 Division of Epidemiology and Community Health, University of Minnesota School of Public Health , Minneapolis, Minnesota.

出版信息

J Womens Health (Larchmt). 2017 Jun;26(6):609-615. doi: 10.1089/jwh.2016.5965. Epub 2017 Mar 23.

Abstract

BACKGROUND

To evaluate clinician and patient attitudes toward home self-collected human papillomavirus (HPV) testing for cervical cancer screening.

METHODS

Women aged 21-65 years were recruited for a randomized trial comparing home self-collected HPV testing to standard clinician-collected Pap screening. Participants were surveyed about their attitudes toward self-collected HPV testing. Clinicians performing cervical cancer screening in University of Washington medical clinics were also surveyed to determine their acceptability of self-collected HPV testing.

RESULTS

Over half (59.1%) of the 1,769 women surveyed preferred self-collected HPV testing to clinician-collected tests. Reasons most often cited were convenience or time saving (82.7%), and avoiding embarrassment or discomfort associated with pelvic exam (38.1%). Women who did not prefer self-collected HPV testing reported greater faith in clinician-collected samples (56.7%) or a desire for a clinic visit to address other issues (42.4%). One hundred eighteen (49.6%) of 238 physicians and midlevel providers surveyed completed the survey. The majority (78.0%) reported that they would recommend a self-collected HPV test if the test had qualities such as high sensitivity and cost effectiveness. Provider concerns mirrored those of patients, namely ensuring adequate sample collection and the opportunity to address other health concerns.

CONCLUSION

Patients and clinicians are supportive of self-collected HPV testing. However, concerns regarding adequacy of samples that are self collected and the desire to see a provider in a clinic setting for other health needs highlight areas that need to be addressed if self collection proves to be a viable option for cervical cancer screening.

摘要

背景

评估临床医生和患者对用于宫颈癌筛查的家庭自行采集人乳头瘤病毒(HPV)检测的态度。

方法

招募年龄在21至65岁之间的女性参与一项随机试验,比较家庭自行采集HPV检测与标准的临床医生采集巴氏涂片筛查。对参与者进行调查,了解她们对自行采集HPV检测的态度。还对在华盛顿大学医学诊所进行宫颈癌筛查的临床医生进行了调查,以确定他们对自行采集HPV检测的接受程度。

结果

在接受调查的1769名女性中,超过一半(59.1%)的人更喜欢自行采集HPV检测,而不是临床医生采集的检测。最常提到的原因是方便或节省时间(82.7%),以及避免与盆腔检查相关的尴尬或不适(38.1%)。不喜欢自行采集HPV检测的女性表示,她们更相信临床医生采集的样本(56.7%),或者希望去诊所就诊以解决其他问题(42.4%)。在接受调查的238名医生和中级医疗人员中,有118人(49.6%)完成了调查。大多数人(78.0%)表示,如果自行采集HPV检测具有高灵敏度和成本效益等特点,他们会推荐这种检测。医疗人员的担忧与患者的担忧类似,即确保样本采集充分以及有机会解决其他健康问题。

结论

患者和临床医生都支持自行采集HPV检测。然而,如果自行采集被证明是宫颈癌筛查的可行选择,那么对自行采集样本的充分性的担忧以及在诊所环境中因其他健康需求而希望见到医疗人员的愿望,凸显了需要解决的问题。

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