Coordinació de l'Estratègia de Càncer de les Illes Balears, Directorate General of Public Health, Balearic Health Ministry, 07010, Palma de Mallorca, Illes Balears, Spain.
Research group on Public Health of Balearic Islands (GISPIB), Health Research Institute of the Balearic Islands (IdISBa), 07010, Palma de Mallorca, Illes Balears, Spain.
Sci Rep. 2023 Feb 16;13(1):2809. doi: 10.1038/s41598-023-29255-y.
The newest high-risk human papillomavirus (HPV) detection techniques were included for cervical cancer primary screening under the Spanish National Health System in 2019. These analyses allow changing population approaches to foster adherence to screening. Therefore, the validity of self versus conventional sampling for HPV and cytology analyses was appraised. Women's preferences concerning samples and devices were also evaluated. This is a diagnostic accuracy cross-sectional study among 120 women recruited from a colposcopy clinic at a general hospital in Illes Balears, Spain. Participants were given written information and asked for a self-sample. One of two sets containing two devices each were handed. One set was transported dry and the second in liquid medium. Next, clinicians collected vaginal samples that were our gold standards. The agreement between both techniques was examined with the Kappa coefficient (κ). Self-sampling evaluation and preferences for different vaginal devices were also surveyed. The agreement between self and conventional samples concerning HPV positivity was very good (κ 0.86 for Mía by XytoTest® and 0.83 for Viba-Brush®) or reasonable (κ 0.73 for Iune and 0.68 for viscose swab). Pap smears from self-samples exhibited moderate agreement (κ 0.41 for Mía® and 0.51 for Viba-Brush® respectively) for negative versus ASC-US and worse results. Most of the participants considered self-sampling as beneficial (110 or 91.7%) and the advantages were, in decreasing order, scheduling, comfort, intimacy and less fear for pain or disturbance. The priority of choice for the devices was Mía® and viscose swab (chosen in first or second place) in opposition to Iune and Viba-Brush® (chosen in third or fourth place). If Viba-Brush® was to collect the best quality samples, 108 women (94.7%) switched their decisions. Our agreement between self and conventional samples was very good or reasonable for HPV, with the best values for devices in a liquid medium, and moderate for cytology. Even so, reflex cytology on self-samples is a valuable tool in promoting adherence. Self-sampling was widely accepted for smooth and thin devices. However, there is no resistance to change to others if a higher quality of the sample is obtained.
2019 年，西班牙国家卫生系统将最新的高危型人乳头瘤病毒（HPV）检测技术纳入宫颈癌初筛。这些分析允许改变人群方法，以促进对筛查的依从性。因此，评估了自我采样与传统采样用于 HPV 和细胞学分析的有效性。还评估了女性对样本和设备的偏好。这是在西班牙巴利阿里群岛一家综合医院的阴道镜诊所招募的 120 名女性中进行的一项诊断准确性横断面研究。参与者获得了书面信息，并被要求进行自我采样。为每位参与者提供了两套各包含两个设备的采样套件。一套是干运输的，另一套是液体运输的。接下来，临床医生采集阴道样本作为金标准。使用 Kappa 系数（κ）检查两种技术之间的一致性。还调查了自我采样评估和对不同阴道设备的偏好。自我采样和传统样本在 HPV 阳性方面的一致性非常好（Mía by XytoTest®的 κ 值为 0.86，Viba-Brush®的 κ 值为 0.83）或合理（Iune 的 κ 值为 0.73，viscose swab 的 κ 值为 0.68）。自我样本的巴氏涂片对于阴性与 ASC-US 的结果具有中度一致性（Mía®的 κ 值分别为 0.41 和 Viba-Brush®的 κ 值为 0.51），结果更差。大多数参与者认为自我采样有益（110 名或 91.7%），其优点按降序排列为：安排方便、舒适、私密和减少对疼痛或干扰的恐惧。对设备的首选是 Mía®和粘丝拭子（首选第一或第二位），而 Iune 和 Viba-Brush®（选择第三或第四位）。如果 Viba-Brush®可以采集到最佳质量的样本，那么 108 名女性（94.7%）改变了选择。自我采样与传统样本的 HPV 结果之间的一致性非常好或合理，液体介质中的设备值最好，细胞学结果为中度。即便如此，自我样本的细胞学反射检查是促进依从性的有价值的工具。自我采样广泛适用于平滑且较薄的设备。但是，如果可以获得更高质量的样本，那么对其他设备的阻力就会降低。
