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柬埔寨应用 careHPV 进行自我采样人乳头瘤病毒检测的可行性、准确性和可接受性:一项横断面研究。

Feasibility, accuracy and acceptability of self-sampled human papillomavirus testing using careHPV in Cambodia: a cross-sectional study.

机构信息

Department of Obstetrics and Gynecology, National Maternal and Child Health Center, Phnom Penh, Cambodia.

Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.

出版信息

J Gynecol Oncol. 2024 Jan;35(1):e6. doi: 10.3802/jgo.2024.35.e6. Epub 2023 Sep 11.

Abstract

OBJECTIVE

Self-sampled human papillomavirus (HPV) testing is a potential option for cervical cancer screening, but research is scarce in Cambodia. We evaluated the feasibility, accuracy, and acceptability of self-sampled HPV testing using careHPV.

METHODS

A cross-sectional study including women aged 20-49 years attending 2 national hospitals in the capital city was conducted. Women underwent both self-sampling and clinician-sampling of specimens, and were then asked to complete an acceptability questionnaire. The paired samples were analyzed for high-risk HPV by careHPV and genotyped by polymerase chain reaction (PCR).

RESULTS

A total of 375 women were eligible for inclusion. Based on PCR, 78.9% were negative for HPV in both self and clinician-samples, 9.9% had a complete HPV type match, and 6.1% had all HPV types in clinician-samples also detected in self-samples. In 5.1%, one or more HPV types identified in the clinician-samples were missed in self-samples. When using careHPV, the overall agreement between the 2 sampling methods was 95.7% (95% confidence interval [CI]=95.8-95.6) with good concordance (κ=0.66, 95% CI=0.56-0.76). Nearly 90% of the women preferred clinician-sampling over self-sampling, citing greater comfort, ease, and speed.

CONCLUSION

Self-sampled HPV testing using careHPV could be an option for cervical cancer screening in Cambodia; however, it requires periodic quality control of handling procedures. In addition, women's health education regarding the accuracy of self-sampled HPV testing and the importance of follow-up in cases of positive results is needed.

摘要

目的

自我采样人乳头瘤病毒(HPV)检测可能是宫颈癌筛查的一种选择,但柬埔寨的相关研究较少。我们评估了使用 careHPV 进行自我采样 HPV 检测的可行性、准确性和可接受性。

方法

这是一项在首都的 2 家国家医院就诊的 20-49 岁女性参与的横断面研究。女性接受自我采样和临床医生采样,并完成一份可接受性问卷。careHPV 对配对样本进行高危 HPV 分析,并通过聚合酶链反应(PCR)进行基因分型。

结果

共有 375 名女性符合纳入条件。基于 PCR,78.9%的女性在自我和临床医生样本中均为 HPV 阴性,9.9%的女性 HPV 类型完全匹配,6.1%的女性在临床医生样本中检测到的所有 HPV 类型也在自我样本中检测到。在 5.1%的女性中,临床医生样本中发现的一种或多种 HPV 类型在自我样本中漏检。当使用 careHPV 时,两种采样方法的总体一致性为 95.7%(95%置信区间[CI]=95.8-95.6),具有良好的一致性(κ=0.66,95%CI=0.56-0.76)。近 90%的女性更喜欢临床医生采样而不是自我采样,认为其更舒适、更轻松、速度更快。

结论

使用 careHPV 进行自我采样 HPV 检测可能是柬埔寨宫颈癌筛查的一种选择;然而,需要定期对处理程序进行质量控制。此外,还需要对女性进行自我采样 HPV 检测准确性和阳性结果随访重要性的健康教育。

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