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通过数字化平台对不列颠哥伦比亚省低筛查率地区提供宫颈癌自我筛查。

Self-Screening for Cervical Cancer Offered through a Digital Platform in a Region of British Columbia with Lower Screening Rates.

机构信息

Women's Health Research Institute, Vancouver, BC V6H 3N1, Canada.

BC Cancer, Vancouver, BC V5Z 4E6, Canada.

出版信息

Curr Oncol. 2024 Sep 13;31(9):5399-5411. doi: 10.3390/curroncol31090399.

Abstract

Cervical cancer is highly preventable through vaccination, early detection, and treatment, yet is the fourth most common cancer globally. HPV testing is superior to cytology for the detection of cervical pre-cancer, and jurisdictions around the world are implementing HPV primary screening, which offers the opportunity for self-screening, an important self-care intervention. Digital health solutions are also increasingly important components of self-care. In this study, we assessed the acceptability and completion of self-screening for cervical cancer offered through a digital platform within a low screening uptake region of British Columbia. The primary objective of this study was to evaluate the acceptability of self-screening for cervical cancer offered through a digital platform as measured by return rates of self-screening kits. Patients due or overdue for cervix screening were invited to participate. Eligible participants registered online to receive a self-screening kit, which included a device for vaginal self-screening, instructions, and a return envelope, sent to their home. After self-screening using the vaginal device, HPV testing was conducted. HPV-negative participants were returned to routine screening, and HPV-positive participants were recommended for cytology or colposcopy. Attendance rates at follow-up were evaluated. Participants were invited to complete an acceptability survey. From April 2019 to December 2023, 283 participants were sent kits, with 207 kits returned for a completion rate of 73%. Of valid samples (n = 202), 15 were HPV positive, and 93% attended follow-up care. Most respondents found the CervixCheck website easy to use, informative, and secure and were satisfied with receiving their results online. CervixCheck had a high completion rate among participants who were sent a self-screening kit. High compliance with recommended follow-up and high acceptability of self-screening for cervical cancer was observed. Most participants indicated they would self-screen again in the future. Innovative approaches to cervical screening, including self-screening and the use of digital health interventions, are ways to enhance equity and improve uptake of cervical screening.

摘要

宫颈癌通过疫苗接种、早期发现和治疗是高度可预防的,但仍是全球第四大常见癌症。HPV 检测在宫颈癌前病变的检测方面优于细胞学检查,世界各地的司法管辖区正在实施 HPV 初筛,这为自我筛查提供了机会,是一项重要的自我护理干预措施。数字健康解决方案也是自我护理的重要组成部分。在这项研究中,我们评估了在不列颠哥伦比亚省一个低筛查参与率地区通过数字平台提供的宫颈癌自我筛查的可接受性和完成情况。这项研究的主要目的是评估通过数字平台提供的宫颈癌自我筛查的可接受性,其测量指标是自我筛查包的返回率。我们邀请了即将进行或已超过宫颈筛查时间的患者参与。符合条件的参与者在线注册,以接收自我筛查包,其中包括用于阴道自我筛查的设备、说明和寄回的信封。使用阴道设备进行自我筛查后,进行 HPV 检测。HPV 阴性的参与者返回常规筛查,HPV 阳性的参与者被推荐进行细胞学检查或阴道镜检查。我们评估了随访的出席率。参与者被邀请完成一项可接受性调查。从 2019 年 4 月至 2023 年 12 月,共向 283 名参与者发送了试剂盒,其中有 207 个试剂盒返回,完成率为 73%。在有效的样本中(n=202),15 个 HPV 呈阳性,93%的人参加了随访。大多数受访者认为 CervixCheck 网站易于使用、信息丰富且安全,并对在线获取结果感到满意。在收到自我筛查包的参与者中,CervixCheck 的完成率很高。我们观察到对推荐的后续行动的高度依从性和对宫颈癌自我筛查的高度可接受性。大多数参与者表示他们将来会再次自我筛查。创新的宫颈癌筛查方法,包括自我筛查和使用数字健康干预措施,是提高公平性和增加宫颈癌筛查参与度的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5e3/11431596/ed0b563f7855/curroncol-31-00399-g001.jpg

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