Department of Obstetrics and Gynaecology, GKNM Hospital, Coimbatore, India.
VN Cancer Centre, GKNM Hospital, Coimbatore, India.
Asian Pac J Cancer Prev. 2024 Feb 1;25(2):419-424. doi: 10.31557/APJCP.2024.25.2.419.
To introduce HPV self-sampling and out-reach colposcopy clinic as interventions to improve the follow-up of HPV positive women in a community based cervical cancer screening programme.
This was a prospective observational study conducted during October 2017 to August 2019 and 2977 women underwent cervical cancer screening using CareHPV test. Follow up colposcopy for HPV positive women were conducted at the rural health center and alternatively as out-reach clinics in their own villages and default rates were compared. HPV positive women were followed up at one-year. They were given an option of either having a follow-up HPV test performed by a health care worker (HCW) or by self-sampling. Compliance to follow up in these two modalities were compared. A validated questionnaire was given to women who had given an HPV self-sample to assess their awareness about HPV and cervical cancer.
During our initial round of cervical cancer screening using HPV as a primary screening modality, our HPV screen positive rate was 7.05% (210 out of 2977 women screened). Our colposcopy rates following an initial invitation at the rural health centre was only 28.5%. Following this, we initiated out-reach colposcopy clinics at their own villages for HPV positive women and this increased colposcopy rates from 28.5% to 45.2%. The participation rate at one-year follow-up was increased from 40.5% to 60% by the introduction of self-sampling as a follow up option and 16.2% of women who were initially positive remained HPV positive at 12-14 months follow up. All women who were offered the option of self-sampling preferred it over a HCW collected sample.
Our study showed that self-sampling could also be used effectively in the follow up of HPV positive women in the community. Outreach colposcopy clinics in their own villages enabled better follow up of HPV positive women.
介绍 HPV 自我采样和外展阴道镜诊所，作为改善社区为基础的宫颈癌筛查计划中 HPV 阳性女性随访的干预措施。
这是一项前瞻性观察研究，于 2017 年 10 月至 2019 年 8 月进行，共有 2977 名妇女接受了 CareHPV 检测的宫颈癌筛查。对 HPV 阳性妇女的随访阴道镜检查在农村卫生中心进行，或者作为其所在村庄的外展诊所进行，并比较失访率。HPV 阳性妇女在一年后进行随访。为她们提供了两种选择，即由医护人员（HCW）进行随访 HPV 检测或自我采样。比较这两种方法的依从性。对接受 HPV 自我采样的妇女进行了一项经过验证的问卷调查，以评估她们对 HPV 和宫颈癌的认识。
在我们首次使用 HPV 作为主要筛查方法进行宫颈癌筛查期间，我们的 HPV 筛查阳性率为 7.05%（2977 名筛查妇女中有 210 名阳性）。在农村卫生中心首次邀请后，我们的阴道镜检查率仅为 28.5%。在此之后，我们为 HPV 阳性妇女在其所在村庄开展了外展阴道镜诊所，将阴道镜检查率从 28.5%提高到 45.2%。通过引入自我采样作为随访选择，将一年随访的参与率从 40.5%提高到 60%，并且在 12-14 个月的随访中，最初阳性的 16.2%的妇女仍然 HPV 阳性。所有提供自我采样选择的妇女都更喜欢这种选择而不是由 HCW 采集的样本。
我们的研究表明，自我采样也可以在社区中 HPV 阳性女性的随访中有效使用。在自己的村庄开展外展阴道镜诊所可以更好地随访 HPV 阳性妇女。
