How to improve cervical cancer screening in Switzerland?

Petignat, Patrick; Untiet, Sarah; Vassilakos, Pierre

doi:10.4414/smw.2012.13663

Cited by 9 publications

(16 citation statements)

References 19 publications

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“…Current data indicate that testing for high-risk human papillomavirus (HPV) types could be used as a primary screening method, and allowing women to do the sampling by themselves (Self-HPV) has been shown to have results similar to those obtained by health care professionals [5-8]. In countries with an existing cervical cancer screening program, Self-HPV is regarded as a possible alternative for women who decline to participate in the existing screening programms [9,10]. Many developing countries have limited or no screening resources, due to the prohibitively high cost of cytology-based screening and lack of qualified health care professionals.…”

Section: Introductionmentioning

confidence: 99%

Randomized comparison of vaginal self-sampling by standard vs. dry swabs for Human papillomavirus testing

et al. 2013

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BackgroundTo evaluate if human papillomavirus (HPV) self-sampling (Self-HPV) using a dry vaginal swab is a valid alternative for HPV testing.MethodsWomen attending colposcopy clinic were recruited to collect two consecutive Self-HPV samples: a Self-HPV using a dry swab (S-DRY) and a Self-HPV using a standard wet transport medium (S-WET). These samples were analyzed for HPV using real time PCR (Roche Cobas). Participants were randomized to determine the order of the tests. Questionnaires assessing preferences and acceptability for both tests were conducted. Subsequently, women were invited for colposcopic examination; a physician collected a cervical sample (physician-sampling) with a broom-type device and placed it into a liquid-based cytology medium. Specimens were then processed for the production of cytology slides and a Hybrid Capture HPV DNA test (Qiagen) was performed from the residual liquid. Biopsies were performed if indicated. Unweighted kappa statistics (к) and McNemar tests were used to measure the agreement among the sampling methods.ResultsA total of 120 women were randomized. Overall HPV prevalence was 68.7% (95% Confidence Interval (CI) 59.3–77.2) by S-WET, 54.4% (95% CI 44.8–63.9) by S-DRY and 53.8% (95% CI 43.8–63.7) by HC. Among paired samples (S-WET and S-DRY), the overall agreement was good (85.7%; 95% CI 77.8–91.6) and the κ was substantial (0.70; 95% CI 0.57-0.70). The proportion of positive type-specific HPV agreement was also good (77.3%; 95% CI 68.2-84.9). No differences in sensitivity for cervical intraepithelial neoplasia grade one (CIN1) or worse between the two Self-HPV tests were observed. Women reported the two Self-HPV tests as highly acceptable.ConclusionSelf-HPV using dry swab transfer does not appear to compromise specimen integrity. Further study in a large screening population is needed.Trial registrationClinicalTrials.gov: NCT01316120

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Section: Introductionmentioning

confidence: 99%

Randomized comparison of vaginal self-sampling by standard vs. dry swabs for Human papillomavirus testing

et al. 2013

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“…Gynecologists and general physicians (GPs) in Switzerland have been promoting CC screening since the late 1960s, in this way achieving a reduction of the CC incidence by ∼60% (Bouchardy et al , 1990; Petignat et al , 2012). The country has an opportunistic screening system, which is essentially based on the gynecologists’ and GPs’ invitation for a periodic control (Petignat et al , 2012). This means that, in the absence of an organised screening program, women are only screened based on their own initiative and that of their physician (Vassilakos et al , 2015).…”

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confidence: 99%

“…This means that, in the absence of an organised screening program, women are only screened based on their own initiative and that of their physician (Vassilakos et al , 2015). As it is an opportunistic system, the relative statistics are difficult to monitor and the only available data come from population-based surveys conducted by the Swiss Federal Office of Public Health (FOPH) and the National Institute for Cancer Epidemiology (NICER; Petignat et al , 2012). …”

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confidence: 99%

Self-sampling to improve cervical cancer screening coverage in Switzerland: a randomised controlled trial

et al. 2017

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Background:The aim of this study is to evaluate whether self-sampling can increase screening attendance of women who do not attend regular screening in Switzerland.Methods:Participants were proactively recruited in Geneva between September 2011 and November 2015. Women (25–69 years) who had not undergone CC screening in the last 3 years were considered eligible. Through a 1 : 1 ratio randomisation, enrolled participants were invited to either undergo liquid-based cytology, which was performed by a health-care provider (control group, CG) or to take a self-sample for HPV-testing, which was mailed to their home (intervention group, IG).Results:A total of 331 and 336 women were randomised in the CG and in the IG, respectively. Overall, 7.3% (95% CI: 4.9–10.6) women in the CG and 5.7% (95% CI: 3.6–8.7) women in the IG did not undergo the initial screening (P=0.400). There were 1.95% (95% CI: 0.8–4.3) women in the CG and 5.05% (95% CI: 3.1–8.1) women in the IG with a positive screen who did not attend triage and colposcopy (P=0.036).Conclusions:The participation in CC screening in women offered self-sampling was not higher than among those offered specimen collection by a clinician. Compliance with further follow-up for women with a positive HPV test on the self-sample requires further attention.

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“…4 However, in 2008, more than half of the European countries had no organized programmes, and opportunistic screening is still the only option available in some of these countries. [5][6][7][8][9][10] Although both can be responsible for the decline in cervical cancer mortality, 11,12 organized screening has the advantage of contributing to reduce the inequalities in the access to early detection, in addition to a higher cost-effectiveness. 12 In Portugal, the region of Centro has organized screening since the 1990s 13 and Alentejo since 2007.…”

mentioning

confidence: 99%

Cytology use for cervical cancer screening in Portugal: results from the 2005/2006 National Health Survey

Oliveira

Peleteiro

Lunet

2013

The European Journal of Public Health

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How to improve cervical cancer screening in Switzerland?

Cited by 9 publications

References 19 publications

Randomized comparison of vaginal self-sampling by standard vs. dry swabs for Human papillomavirus testing

Randomized comparison of vaginal self-sampling by standard vs. dry swabs for Human papillomavirus testing

Self-sampling to improve cervical cancer screening coverage in Switzerland: a randomised controlled trial

Cytology use for cervical cancer screening in Portugal: results from the 2005/2006 National Health Survey

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