Self-sampling HPV test in women not undergoing Pap smear for more than 5 years and factors associated with under-screening in Taiwan

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• 作者：Hung-Hsueh Chou^a ; ^b ; ^g ; ^{ma2012@cgmh.org.tw} ; Huei-Jean Huang^a ; ^b ; ^g ; Hui-Hsin Cheng^b ; ^g ; Chee-Jen Chang^c ; Lan-Yan Yang^b ; ^d ; Chu-Chun Huang^a ; ^b ; Wei-Yang Chang^d ; Swei Hsueh^b ; ^e ; Angel Chao^a ; ^b ; Chin-Jung Wang^a ; ^b ; Yun-Hsin Tang^a ; ^b ; Cheng-Tao Lin^a ; ^b ; Jian-Tai Qiu^a ; ^b ; Min-Yu Chen^a ; ^b ; Chao-Yu Chen^a ; ^b ; Kuan-Gen Huang^a ; ^b ; Tzu-Chun Tsai^f ; Ting-Chang Chang^a ; ^b ; Chyong-Huey Lai^a ; ^b ; ^{sh46erry@ms6.hinet.net}
• 关键词：cervical neoplasms ; human papillomavirus ; Pap smear ; self-sampling ; screening rate
• 刊名：Journal of the Formosan Medical Association
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：115
• 期：12
• 页码：1089-1096
• 全文大小：538 K
• 卷排序：115

文摘

Under-utilization of Papanicolaou (Pap) smear causes a gap in the prevention of cervical neoplasms. A prospective population-based study was conducted investigating whether a self-sampling human papillomavirus (HPV) test was feasible for under-users of Pap smear and factors associated with under-screening in Taiwan.MethodsWomen not having Pap smear screening for > 5 years were invited to participate in this study. Invitation letters and educational brochures were mailed to 4% of randomly selected eligible women from Taoyuan City, Taiwan, and responders received an HPV self-sampling kit. Those with HPV-positive results were recalled for a Pap smear and colposcopy.ResultsBetween March 2010 and June 2012, 10,693 women were invited, 354 responded (3.3%), and 282 (2.6%) gave valid informed consent, answered the questionnaire, and submitted HPV samples. The median age of enrolled women was 48.1 years. Forty-seven women (16.7%) had a positive HPV test, and 14 women accepted further survey to find two CIN2+. Another two cases of CIN2+ were identified from a national registry database. The cost of direct mailing self-samplers was less than that done on request (from NT$434,866 to NT$164,229, response rate of 5% to 15%, respectively, versus NT$683,957 for detecting 1 CIN2+). Reasons for not attending screening included lack of time, embarrassment, assumed low risk, fear of positive results, and perceived potential pain. Among the responders, 90.8% found the method acceptable.ConclusionOur study indicated that different approaches (e.g., direct mailing self-samplers to under-users and/or various educational interventions) must be explored to improve coverage in populations with culture characteristics similar to Taiwan.