Implementation Science team, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA.
Public Health Research Institute of India, Mysore, Karnataka, India.
Int J Gynaecol Obstet. 2019 Aug;146(2):170-176. doi: 10.1002/ijgo.12859. Epub 2019 May 30.
To examine the feasibility of implementing a high-risk HPV (hrHPV) DNA-based screening program for cervical cancer and the prevalence of hrHPV DNA-positive women in a community setting in rural India.
A cross-sectional study was conducted at the community level in the Hunsur taluk of the Mysore district from January to August 2016. Cervical cancer screening was conducted with self-collected vaginal samples that were analyzed using the Hybrid Capture 2 (HC2) assay (Qiagen, USA).
The majority of participants were aged 30-39 years, with no formal schooling, from a lower caste, and lived below an annual household income of US$1499. After group health education and one-on-one counseling, a total of 473 women underwent self-sampling. Of these, 36 (7.6%) were positive for hrHPV and only 24 (66.6%) underwent follow-up diagnostic triaging. Cancer was detected in two women, who were referred to appropriate healthcare facilities for further treatment.
Implementation of hrHPV DNA-based screening tests using self-sampling can be feasible in rural settings in India. However, substantial resources are required for providing health education and one-on-one counseling to inform asymptomatic women about the benefits of testing and, more importantly, to improve compliance with follow-up.
在印度农村社区环境中，检验实施高危型人乳头瘤病毒（hrHPV）DNA 筛查宫颈癌方案的可行性，以及 hrHPV DNA 阳性妇女的流行率。
2016 年 1 月至 8 月，在迈索尔区 Hunsur 县的社区层面开展了一项横断面研究。采用自我采集的阴道样本进行宫颈癌筛查，这些样本使用杂交捕获 2（HC2）检测法（美国凯杰公司）进行分析。
大多数参与者年龄在 30-39 岁，未接受正规教育，出身较低种姓，家庭年收入低于 1499 美元。在开展群体健康教育和一对一咨询后，共有 473 名妇女进行了自我采样。其中，36 名（7.6%）hrHPV 检测呈阳性，仅有 24 名（66.6%）接受了后续诊断性分检。两名妇女确诊为癌症，被转介到适当的医疗机构进行进一步治疗。
在印度农村地区，使用自我采样实施基于 hrHPV DNA 的筛查测试可能是可行的。但是，需要大量资源来提供健康教育和一对一咨询，使无症状妇女了解检测的益处，更重要的是，提高对后续检测的依从性。
