对于已经接受过高级别宫颈上皮内瘤变治疗的女性，自我取样检测高危型人乳头瘤病毒是否是一种可以接受的选择？
Is self-sampling to test for high-risk papillomavirus an acceptable option among women who have been treated for high-grade cervical intraepithelial neoplasia?
机构信息
Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.
Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden.
出版信息
PLoS One. 2018 Jun 18;13(6):e0199038. doi: 10.1371/journal.pone.0199038. eCollection 2018.
OBJECTIVE
Self-sampling to test for high risk human papilloma virus (HPV) is becoming an increasingly important component of cervical cancer screening. The aim of this observational study is to examine how women treated for high-grade cervical intraepithelial neoplasia (CIN) view HPV self-sampling.
METHODS
Invited to participate in the present study were patients who had undergone treatment of high-grade CIN (grade 2 or higher) and were followed-up at 6-months at the Karolinska University Hospital, Stockholm. The participants were instructed as to how to perform HPV self-sampling. Thereafter, the participants completed a questionnaire about HPV self-sampling and other cervical cancer screening methods, as well as about self-perceived risk of cervical cancer without regular gynecologic follow-up and about specific knowledge regarding HPV, CIN and cervical cancer.
RESULTS
Altogether 479 women enrolled in this study. The participation rate was 96.6%. Nearly 75% of the participants stated they would consider performing the HPV self-sampling prior to their next gynecologic follow-up. Confidence in HPV self-sampling was a significant independent predictor of willingness to perform HPV self-sampling. However, confidence in HPV self-sampling was significantly lower than confidence in Papanicolaou smears and in HPV testing with samples collected by health professionals. Higher specific knowledge about HPV, CIN and cervical cancer was also a significant independent predictor of willingness to perform HPV self-sampling, as was having travelled longer distance to attend gynecologic follow-up. Participants with lower income and without completed university education expressed significantly higher confidence in HPV self-sampling and lower confidence in Papanicolaou smears than the other women.
CONCLUSIONS
To the best of our knowledge, this is the first study to examine the views of women treated for high-grade CIN vis-à-vis HPV self-sampling. The latter is an acceptable option for the vast majority of this cohort of women.
目的
自我采样检测高危型人乳头瘤病毒（HPV）正逐渐成为宫颈癌筛查的重要组成部分。本观察性研究旨在调查已接受高级别宫颈上皮内瘤变（CIN）治疗的女性如何看待 HPV 自我采样。
方法
邀请在斯德哥尔摩卡罗林斯卡大学医院接受高级别 CIN（2 级或更高级别）治疗并在 6 个月时进行随访的患者参与本研究。向参与者说明如何进行 HPV 自我采样。之后，参与者填写了一份关于 HPV 自我采样和其他宫颈癌筛查方法的问卷，以及关于未经常规妇科随访时的宫颈癌自我感知风险和关于 HPV、CIN 和宫颈癌的具体知识。
结果
本研究共纳入 479 名女性，参与率为 96.6%。近 75%的参与者表示她们会考虑在下一次妇科随访前进行 HPV 自我采样。对 HPV 自我采样的信心是愿意进行 HPV 自我采样的显著独立预测因素。然而，对 HPV 自我采样的信心明显低于对巴氏涂片和由卫生专业人员采集样本的 HPV 检测的信心。HPV、CIN 和宫颈癌的特定知识较高也是愿意进行 HPV 自我采样的显著独立预测因素，此外，长途旅行来接受妇科随访的意愿也较强。收入较低和未完成大学教育的参与者对 HPV 自我采样的信心明显较高，对巴氏涂片的信心明显较低。
结论
据我们所知，这是第一项调查已接受高级别 CIN 治疗的女性对 HPV 自我采样看法的研究。对于大多数接受治疗的女性来说，HPV 自我采样是一种可接受的选择。
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