Primary screening for cervical cancer through self sampling

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• 作者：F. Holanda ; Jr. ; A. Castelo ; T.M.C.W. Veras ; F.M.L. de Almeida ; M.Z. Lins and G.B. Dores
• 刊名：International Journal of Gynecology and Obstetrics
• 出版年：2006
• 出版时间：November 2006
• 年：2006
• 卷：95
• 期：2
• 页码：179-184
• 全文大小：84 K

文摘

Objective

To evaluate the use of community health agents (CHAs) to instruct women living in poor rural areas in obtaining self-collected cervical samples and compare the high-risk HPV (hrHPV) hybrid capture (HC) results obtained to those for gynecologist-collected samples.

Methods

After a one-day training, CHAs visited sexually active women, instructing each in the use of collection brush and the Universal Collection Medium tube. One week thereafter, a gynecologist collected cervical samples from, and performed colposcopies on, the same women. A single reference lab performed all HCs.

Results

878 women (Age: 15–69 years) participated. Among self-collected samples, hrHPV prevalence was 33.9 % (95 % CI: 30.8 % –37 % ), compared with 28.6 % (95 % CI: 27 % –30 % ) among gynecologist-collected samples. However, 9.3 % of the patients were HPV HC II-positive in the self-collected sample and HPV HC II-negative in the gynecologist-collected samples (95 % CI: 7.38 % –11.22 % ), whereas 4 % tested positive in gynecologist-collected samples and negative in self-collected samples (95 % CI: 2.7 % –5.3 % ) (P < 0.01; kappa = 0.7). Of 9 cases of histologically-confirmed, high-grade squamous intraepithelial lesion, self-collected and provider-collected samples missed one each.

Conclusion

Self-collected vaginal sampling could be made an additional CHA function under existing program conditions, improving access to cervical cancer screening in poor rural settings.