Sex Transm Dis. 2018 Jan;45(1):42-48. doi: 10.1097/OLQ.0000000000000681.
Testing for high-risk human papillomavirus (HPV) infection using mailed, self-collected samples is a promising approach to increase screening in women who do not attend clinic screening at recommended intervals.
To assess this intervention among high-risk women in the United States, 429 women without a Papanicolaou (Pap) test in 4 or more years (overdue by US guidelines) were recruited from the general population. Participants aged 30 to 65 years were mailed a kit to self-collect a cervicovaginal sample at home, return the sample by mail, and receive HPV results by telephone, with referral to follow-up cytological Pap testing at a local clinic. Cervicovaginal self-samples were collected with a Viba brush, stored in Scope mouthwash, and tested by Hybrid Capture 2. Data were collected in 2010 to 2011 and analyzed in 2017.
Two-thirds (64%) of participants returned a self-collected sample, of whom 15% tested HPV DNA positive. Human papillomavirus self-test-positive women reported higher rates of follow-up Pap tests (82%) than did those with self-test negative results (51%). No demographic differences were found in self-test return rate or HPV positivity. High acceptability was reported in participant surveys: most women (81%) had "mostly positive" overall thoughts about the self-test, and most reported being comfortable receiving the kit in the mail (99%), returning their self-collected sample by mail (82%), and receiving their test results by telephone (97%).
Conducting HPV self-testing through population-based recruitment, mailed kit delivery and return by mail, and results delivery by telephone has the potential to reach a broad segment of US underscreened women.
通过邮寄、自我采集样本的方式对高危型人乳头瘤病毒（HPV）进行检测，是增加未能按照推荐间隔时间到诊所接受筛查的女性接受筛查的一种很有前景的方法。
为了评估该方法在美国高危女性中的效果，我们从普通人群中招募了 429 名 4 年或以上未进行巴氏涂片（Pap）检测（根据美国指南，已经逾期）的女性。年龄在 30 至 65 岁之间的参与者收到一个试剂盒，可在家中自行采集宫颈阴道样本，通过邮件将样本寄回，并通过电话获得 HPV 检测结果，阳性者将被转诊至当地诊所进行细胞学巴氏涂片检测随访。宫颈阴道自我样本用 Viba 刷采集，储存在 Scope 漱口水内，用 Hybrid Capture 2 进行检测。数据于 2010 年至 2011 年收集，并于 2017 年进行分析。
有三分之二（64%）的参与者寄回了自行采集的样本，其中 15%检测出 HPV DNA 阳性。HPV 自我检测阳性的女性比阴性女性更有可能进行后续 Pap 检测（82%比 51%）。在自我检测样本的返回率或 HPV 阳性率方面，未发现与人口统计学相关的差异。在参与者调查中报告了较高的接受度：大多数女性（81%）对自我检测的总体看法“大多为正面”，大多数女性报告说她们对通过邮件收到试剂盒（99%）、通过邮件寄回自行采集的样本（82%）和通过电话收到检测结果（97%）感到舒适。
通过基于人群的招募、邮寄试剂盒和邮件返回、电话通知检测结果的方式进行 HPV 自我检测，有可能覆盖到美国未充分筛查的广大女性群体。
