Ocean Road Cancer Institute, Dar es Salaam, Tanzania.
Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
JCO Glob Oncol. 2021 Jun;7:985-991. doi: 10.1200/GO.20.00598.
Cervical cancer screening is one of the strategies to prevent the disease among women at risk. Human papillomavirus (HPV) DNA testing is increasingly used as the cervical cancer screening method because of its high sensitivity. Self-collection of cervical specimens has the potential to improve participation. However, there is only limited information on comparison between self-collected and provider-collected samples with regard to detection of high-risk HPV using the careHPV method. The study aimed to compare HPV detection by careHPV in self-collected and provider-collected cervical samples and to assess the acceptability of self-collection techniques.
Women attending cervical cancer screening clinics at Ocean Road Cancer Institute, Kilimanjaro Christian Medical Centre or Mawenzi Hospital in Tanzania were included in the study. They underwent a face-to-face interview, HIV testing, and collected a self-sample using Evalyn Brush. Subsequently, they had a cervical sample taken by a health provider. Both samples were tested for high-risk HPV DNA using careHPV.
Overall, 464 women participated in the study. The high-risk HPV prevalence was 19.0% (95% CI, 15.6 to 22.9) in the health provider samples, but lower (13.8%; 95% CI, 10.9 to 17.3) in the self-collected samples. There was a good overall agreement 90.5% (95% CI, 87.5 to 93.0) and concordance (κ = 0.66; 95% CI, 0.56 to 0.75) between the two sets of samples. Sensitivity and specificity were 61.4% (95% CI, 50.4 to 71.6) and 97.3% (95% CI, 95.2 to 98.7), respectively, varying with age. Most women preferred self-collection (79.8%).
Overall, self-sampling seems to be a reliable alternative to health-provider collection and is acceptable to the majority of women. However, instructions on proper procedures for sample collection to the women are important.
宫颈癌筛查是预防高危女性宫颈癌的策略之一。人乳头瘤病毒（HPV）DNA 检测因其高灵敏度而越来越多地被用作宫颈癌筛查方法。自我采集宫颈标本有可能提高参与度。然而，关于使用 careHPV 方法检测高危 HPV 时，自我采集和医生采集标本之间的比较，仅有有限的信息。本研究旨在比较 careHPV 检测中自我采集和医生采集宫颈标本中 HPV 的检测情况，并评估自我采集技术的可接受性。
坦桑尼亚沿海路癌症研究所、基利马尼基督教医学中心或曼文尼医院的宫颈癌筛查诊所的女性参与了这项研究。她们接受了面对面访谈、HIV 检测，并使用 Evalyn 刷自我采集样本。随后，由一名卫生保健提供者采集她们的宫颈样本。两种样本均使用 careHPV 检测高危 HPV DNA。
总体而言，464 名女性参与了这项研究。卫生保健提供者采集的样本中高危 HPV 患病率为 19.0%（95%CI，15.6 至 22.9），而自我采集的样本中患病率较低（13.8%；95%CI，10.9 至 17.3）。两种样本之间存在良好的总体一致性（90.5%；95%CI，87.5 至 93.0）和一致性（κ=0.66；95%CI，0.56 至 0.75）。灵敏度和特异性分别为 61.4%（95%CI，50.4 至 71.6）和 97.3%（95%CI，95.2 至 98.7），两者均随年龄而变化。大多数女性更喜欢自我采集（79.8%）。
总体而言，自我采样似乎是卫生保健提供者采集的可靠替代方法，且大多数女性都可以接受。然而，向女性提供正确的样本采集程序说明非常重要。
