Self-Sampling for HPV Testing: Increased Cervical Cancer Screening Participation and Incorporation in International Screening Programs

Gupta, Sarah; Palmer, Christina G.S.; Bik, Elisabeth M.; Cárdenas, Juan Pablo; Núñez, Harold; Kraal, Laurens; Bird, Sara; Bowers, Jennie; Smith, Alison M.; Walton, Nathaniel A.; Goddard, Audrey D.; Almonacid, Daniel E.; Richman, Jessica; Apte, Zachary S.

doi:10.20944/preprints201711.0199.v1

Cited by 3 publications

(8 citation statements)

References 9 publications

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“…For our study, we used cervibroom, a standard brush used in gynecology clinics. There have been few other devices like solopap, dacronswabs, and digene conical collection used for this test as well . The cervibroom is already used for pap smears and comes at no extra cost; it is also easy to use.…”

Section: Discussionmentioning

confidence: 99%

“…There have been few other devices like solopap, dacronswabs, and digene conical collection used for this test as well. 19,20,35,36 The cervibroom is already used for pap smears and comes at no extra cost; it is also easy to use. The most important difference is that with cervibroom-collected samples, a liquid-based cytology slide can be made if required.…”

Section: Digenous Women and Mortality Of Indigenous And Torres Straightmentioning

confidence: 99%

“…The relevance of self‐sampling for liquid‐based cytology, allowing for further tests if required, is now even higher, because there is a need of cytology triage for women who are HPV positive after self‐sampling . Previously, most studies on self‐sampling of cervical screening have only been done for detection of HPV . If it were shown to be sufficiently reliable, self‐sampling for assessment of cervical cytology could provide a useful adjunct to existing screening methods …”

Section: Introductionmentioning

confidence: 99%

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Self‐collected Pap smears may provide an acceptable and effective method of cervical cancer screening

Singla

Komesaroff

2018

Health Science Reports

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Background and aimsThe role of the Papanicolou (Pap) smear in the early detection and prevention of cervical cancer is well established. However, many women fail to undertake the test because of embarrassment or other reasons. To address this problem, we evaluated the feasibility of implementing self‐sampling of cervical cytology as an alternative to clinician‐collected Pap smears and compared it with the gold standard of colposcopy in terms of specificity.Materials and methodsA prospective preliminary study of 40 women recruited from the colposcopy clinic of a tertiary referral hospital was undertaken. Participants were instructed in the technique of self‐sampling and asked to collect their own Pap smears. Colposcopic examinations were performed and biopsies taken, if indicated. Clinician‐collected Pap smears were performed 4 weeks later. Pairwise agreement was calculated between the outcomes of self‐collected, colposcopic, and clinician‐collected samples using the weighted κ statistic.ResultsSelf‐collected Pap smear had a high level of acceptability among the women, all of whom were able to collect adequate tissue. The agreement of self‐collected Pap smears with colposcopic assessment was no worse than that of clinician‐collected Pap smears (Cohen's κ statistic 0.54 [95% CI, 0.27‐0.82]; cf 0.49 [0.2‐0.78], respectively). The specificity of self‐collected Pap smears was almost identical to that of clinician‐collected samples (specificity: 86% vs 81%, respectively). Direct comparison between patient and clinician collected Pap smears showed fair agreement (κ statistic 0.38 [0.07‐0.68]). There were no adverse events in either group.ConclusionsSelf‐collection of Pap smears is an effective and acceptable alternative to clinician‐collected samples and may provide a strategy for improving compliance with cervical testing programs.

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Section: Discussionmentioning

confidence: 99%

Section: Digenous Women and Mortality Of Indigenous And Torres Straightmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Self‐collected Pap smears may provide an acceptable and effective method of cervical cancer screening

Singla

Komesaroff

2018

Health Science Reports

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“…Human papillomavirus (HPV) testing has been reported to have high test performance, [11][12][13] and recent advancements in molecular techniques have led to the opportunity to use HPV testing as a screening method in low-income settings. 10 Previously, HPV testing required a gynecological examination; however, a vaginal sample can now be taken by the woman herself, which is referred to as HPV self-sampling or self-testing.…”

Section: Introductionmentioning

confidence: 99%

“…In these settings, HPV self-sampling has been reported to be well-accepted as it addresses many of the barriers that prevent women from attending screening. 12,14 Hence, it has the potential to increase cervical cancer screening uptake. However, studies have shown that some women are concerned about their ability to perform self-collection correctly or they are afraid of experiencing discomfort during the self-collection procedure.…”

Section: Introductionmentioning

confidence: 99%

Acceptability and feasibility of self‐sampling and follow‐up attendance after text message delivery of human papillomavirus results: A cross‐sectional study nested in a cohort in rural Tanzania

Mremi

Linde

Mlay

et al. 2021

Acta Obstet Gynecol Scand

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Introduction The objective was to determine if self‐collection of vaginal samples for human papillomavirus (HPV) testing was acceptable and feasible in rural Tanzania and to assess the extent of attendance at a follow‐up appointment among women who tested HPV‐positive after delivery of HPV results via text messages. Material and methods A combined cross‐sectional and cohort study was conducted among women aged 25‐60 years from rural Kilimanjaro, Tanzania. Women were offered HPV self‐sampling or traditional visual inspection of the cervix with acetic acid. If HPV self‐sampling was preferred, participants received instructions on self‐collection with an Evalyn Brush. A questionnaire was used to assess the acceptability and feasibility of the self‐sampling procedure for the participants and delivery of HPV results via text messages. A mobile text message platform was used to send private text messages with the screening results to the participants. Results A total of 1108 women were enrolled and self‐collected an HPV sample; 11.8% tested positive for high‐risk HPV. The majority (98.9%) agreed that they had no trouble in understanding the instructions on how to perform the self‐collection and that they would recommend it to a friend (94.5%) or as a standard screening method in Tanzania (95.5%). A minority of women experienced bleeding (2.4%) or pain (6%) while collecting the sample, while some were worried that they would get hurt (12.7%) or felt embarrassed (3.5%). The majority (98.4%) of women would like to receive the screening test results via text messages. Eighty‐two per cent of those who tested positive for high‐risk HPV attended the follow‐up appointment after receiving a text message reminder and an additional 16% attended after receiving both a text message and a phone call reminder whereas 2% did not attend follow up at all. Attendance was not influenced by age, marital status, education level, parity, or HIV status. Conclusions Human papillomavirus self‐sampling and text‐message feedback delivery are generally well‐perceived and accepted among rural Tanzanian women, and the majority of HPV‐positive women attended a follow‐up appointment after receiving their HPV results and follow‐up appointment via text messages. This screening method may have potential to be transferrable to other low‐income countries with a high incidence of cervical cancer and so improve cervical cancer screening attendances.

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Cervical Cancer Screening via Self-Sampling for High-Risk Human Papilloma Virus: A Community-Based Pilot Study in Lagos, Nigeria

Oshodi

Adefemi

Olumodeji

et al. 2021

JAMMR

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Background: Cervical cancer is the second most common cancer in women globally after breast cancer. It is a preventable cancer with a well‑defined premalignant phase where treatment could be offered before invasive cancer develops. Objective: To determine the prevalence, socio-demographic characteristics and serotypes of high-risk HPV amongst positive women using self-sampling HPV-based cervical cancer screening. Methods: A cross-sectional pilot study in an urban setting in Lagos, Nigeria where one hundred women, following community-based counselling on cervical cancer and its prevention, underwent cervical cancer screening via self-sampling for hr-HPV. Structured questionnaires were administered for data collection. Appropriate instruction for self-sample collection using Flobam cervical sampling kit was given to each subject. The samples were processed using DNA analysis via PCR (polymerase chain reaction) amplification and flow through hybridization to identify the hr-HPV serotypes. Women who tested positive for hr-HPV had colposcopic-guided biopsy. The data obtained were analysed using SPSS version 20.0. Findings: Almost all (97%) the women were successful at self-sampling. The prevalence of hr-HPV positivity was 19% with peak (31.6%) of hr-HPV positivity observed in subjects aged 31-40 years. HPV 53 was the commonest (36%) serotype, HPV 33 and 39 were the least (7%) identified and 47% of hr-HPV positive subjects had infection with two or more HPV serotypes. Two-third (66.7%) of hr-HPV positive subjects attended follow-up for colposcopy guided biopsy and 10.5% of the hr-HPV positive subjects had premalignant/malignant cervical lesion. Conclusion: Infection with more than one hr-HPV serotype is common in our study. Self-sampling modality of HPV cervical cancer screening is feasible in this environment.

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Self-Sampling for HPV Testing: Increased Cervical Cancer Screening Participation and Incorporation in International Screening Programs

Cited by 3 publications

References 9 publications

Self‐collected Pap smears may provide an acceptable and effective method of cervical cancer screening

Self‐collected Pap smears may provide an acceptable and effective method of cervical cancer screening

Acceptability and feasibility of self‐sampling and follow‐up attendance after text message delivery of human papillomavirus results: A cross‐sectional study nested in a cohort in rural Tanzania

Cervical Cancer Screening via Self-Sampling for High-Risk Human Papilloma Virus: A Community-Based Pilot Study in Lagos, Nigeria

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