Self-Sampling for Human Papillomavirus Testing among Non-Attenders Increases Attendance to the Norwegian Cervical Cancer Screening Programme
Self-Sampling for Human Papillomavirus Testing among Non-Attenders Increases Attendance to the Norwegian Cervical Cancer Screening Programme
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DOI：
10.1371/journal.pone.0151978
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发表时间：
2016-04-13
期刊：
影响因子：
3.7
通讯作者：
Nygard, Mari
中科院分区：
文献类型：
--
作者：
Enerly, Espen;Bonde, Jesper;Nygard, Mari
增加参加筛查的人数为提高完善的宫颈癌筛查计划的有效性提供了最好的潜力。在家中自我采样进行人类乳头瘤病毒(HPV)检测，作为临床采样的替代方案，可能是增加就诊率的有用政策。为了确定自我抽样是否提高了不定期参加挪威宫颈癌筛查计划(NCCSP)的妇女的筛查出勤率，在奥斯陆地区随机选择了800名年龄在25-69岁之间、本应收到第二次提醒参加定期筛查的妇女，并邀请她们成为干预组的一部分。这组女性接受了两种自我采样设备中的一种，Evalyn Brush或Delphi Screener。为了参加筛查，干预组的妇女可以选择使用自我取样设备(自我取样小组)或去医生那里做宫颈涂片。通过CLAT(R)HPV2试验和DIGENE(R)杂交捕获(HC)2试验对自身样本进行裂解，并分析高危(HR)HPV的存在。对照组由2593名妇女组成，根据NCCSP的现行指导方针，她们收到了第二封提示信。干预组出席率为33.4%，对照组为23.2%，两种自检设备出勤率相近。自我抽样小组的女性对这两种自我抽样设备的反应都很好，并表示不记得接到筛查电话是以前没有出席的最主要原因。在自我抽样亚组中，34名hrHPV阳性妇女中有32人(94.1%)接受了随访。总之，自我抽样提高了出席率，是可行的，也是受欢迎的。这项研究进一步支持了自我采样可能是提高挪威宫颈癌筛查覆盖率的有价值的替代方案的提议。
Increasing attendance to screening offers the best potential for improving the effectiveness of well-established cervical cancer screening programs. Self-sampling at home for human papillomavirus (HPV) testing as an alternative to a clinical sampling can be a useful policy to increase attendance. To determine whether self-sampling improves screening attendance for women who do not regularly attend the Norwegian Cervical Cancer Screening Programme (NCCSP), 800 women aged 25-69 years in the Oslo area who were due to receive a 2nd reminder to attend regular screening were randomly selected and invited to be part of the intervention group. Women in this group received one of two self-sampling devices, Evalyn Brush or Delphi Screener. To attend screening, women in the intervention group had the option of using the self-sampling device (self-sampling subgroup) or visiting their physician for a cervical smear. Self-sampled specimens were split and analyzed for the presence of high-risk (hr) HPV by the CLART (R) HPV2 test and the digene (R) Hybrid Capture (HC)2 test. The control group consisted of 2593 women who received a 2nd reminder letter according to the current guidelines of the NCCSP. The attendance rates were 33.4% in the intervention group and 23.2% in the control group, with similar attendance rates for both self-sampling devices. Women in the self-sampling subgroup responded favorably to both self-sampling devices and cited not remembering receiving a call for screening as the most dominant reason for previous non-attendance. Thirty-two of 34 (94.1%) hrHPV-positive women in the self-sampling subgroup attended follow-up. In conclusion, self-sampling increased attendance rates and was feasible and well received. This study lends further support to the proposal that self-sampling may be a valuable alternative for increasing cervical cancer screening coverage in Norway.