Why Consider Self-Sampling for Cervical Cancer Screening in Low- and Middle-Income Countries?

Defo, Victoire Fokom; Domgue, Joël Fokom

doi:10.1001/amajethics.2020.116

Cited by 15 publications

(9 citation statements)

References 23 publications

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“…Furthermore, in HICs, HPV as the primary test for cervical cancer screening has gradually been introduced [17]. Although HPV testing can be done using a self-collected specimen (self-sampling), which can potentially improve the uptake of screening in LMICs, challenges such as autonomy, cost, and limited health care resources need to be addressed [18]. Regardless of the challenges of introducing HPV testing, it is important to evaluate the opportunities for introducing HPV testing as the primary screening method in LMICs.…”

Section: Discussionmentioning

confidence: 99%

“…The Abbott RealTime High-Risk HPV assay (Abbott Molecular GmbH & Co. KG, Wiesbaden, Germany) is a real-time PCR assay that detects 14 hrHPV DNA (16,18,31,33,35,39,45,51,52,56,58,59, 66 and 68) and genotypes only HPV types 16 and 18 from the other 12 hrHPV (non-HPV 16/18) types. A volume of 800 µL of healthcare worker and self-collected samples was transferred into Abbott m2000 Master-Mix tubes, respectively, and loaded into the Abbott m2000sp (Sample Preparation) system for extraction using the mSample Preparation System DNA kit.…”

Section: Abbott Realtime High-risk Hpv Testingmentioning

confidence: 99%

“…An aliquot of 1 mL was transferred from the ThinPrep vial container to an Aptima Specimen Transfer tube containing the medium and tested using APTIMA ® HPV assay (Hologic Gen-Probe, Inc., San Diego, Canada) according to the manufacturer's instructions. The APTIMA ® HPV assay is a target amplification nucleic acid probe test for the in vitro qualitative detection of E6/E7 mRNA from 14 hrHPV types (16,18,31,33,35,39, 45, 51, 52, 56, 58, 59, 66 and 68). The assay did not discriminate between the 14 high-risk types, and the assay results were interpreted based on the signal/cutoff ratio for the analyte.…”

Section: High-risk Hpv Mrna Testingmentioning

confidence: 99%

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High-risk human papillomavirus detection in self-collected vaginal samples compared with healthcare worker collected cervical samples among women attending gynecology clinics at a tertiary hospital in Pretoria, South Africa

Tiiti

Mashishi

Nkwinika

et al. 2021

Virol J

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Background In 2017, the South African National Department of Health (NDoH) Cervical Cancer Prevention and Control Policy was revised. Human papillomavirus (HPV) testing on self-collected samples may offer improved screening uptake. The objectives of the study were to compare the positivity of high-risk (hr)-HPV deoxyribonucleic acid (DNA) and hrHPV viral messenger ribonucleic acid (mRNA) between healthcare worker-collected cervical and self-collected vaginal samples and investigate the accuracy of the applicator-tampon-based self-collected samples in detecting hrHPV DNA and hrHPV mRNA. Methods A total of 527 women aged 18 years and older and seeking gynecology services at a tertiary hospital in Pretoria, South Africa, were enrolled. Vaginal samples were self-collected using SelfCerv applicator tampon, followed by cervical samples collected by a healthcare worker using a Cervex Brush® Combi. Both samples were tested with the Abbott m2000 analyzer for 14-hrHPV types and 285 paired samples were tested for hrHPV E6/E7 mRNA using the Aptima HR-HPV mRNA assay. The prevalence of hrHPV DNA and hrHPV E6/E7 mRNA was estimated and the positivity between the two collection methods was compared for the total group as well as per age group. Results HrHPV prevalence was 48.0% (95% CI 43.7–52.4) among healthcare worker collected samples and 47.6% (95% CI 43.3–52.0) among self-collected samples. There was no difference in positivity between healthcare worker collection (48.0%) and applicator-tampon-based self-collection, 47.6% (p-value = 0.90). The proportions of hrHPV were equal between the age groups as shown by the McNemar test (p = 0.9036) results for correlated proportions. The prevalence of hrHPV mRNA was 78.6% (95% CI 73.4–83.2) and 58.6% (95% CI 52.6–64.4) for healthcare worker- and self-collection, respectively. The McNemar test for correlated proportions was highly significant (p < 0.0001), indicating that the hrHPV mRNA proportions are not comparable, although this differed between age groups. Conclusions Applicator-tampon-based self-collection has a comparable hrHPV DNA positivity rate as healthcare worker collection but different positivity rates for hrHPV mRNA. Self-sampling showed high concordance with healthcare worker-collected sampling for hrHPV DNA detection, especially regarding HPV 16/18 detection. HrHPV DNA was equally detected between the total group as well as per age group. Implementation of self-sampling using an applicator tampon as a primary screening tool may be considered.

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Section: Discussionmentioning

confidence: 99%

Section: Abbott Realtime High-risk Hpv Testingmentioning

confidence: 99%

Section: High-risk Hpv Mrna Testingmentioning

confidence: 99%

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High-risk human papillomavirus detection in self-collected vaginal samples compared with healthcare worker collected cervical samples among women attending gynecology clinics at a tertiary hospital in Pretoria, South Africa

Tiiti

Mashishi

Nkwinika

et al. 2021

Virol J

View full text Add to dashboard Cite

show abstract

“…147,148 Stigma associated with cervical cancer and HPV can influence women's willingness to undergo an HPV test and their interpretation of screening results. 149,150 In some settings, there are pervasive misperceptions that the "type of women" who get cervical cancer are uneducated, sexually promiscuous, and cursed. 77,89,151 Furthermore, HPV testing can raise potentially difficult issues related to trust and fidelity within marriages in cases of a positive test result.…”

Section: Lessons In Women's Preferencesmentioning

confidence: 99%

Cervical Cancer Screening Postpandemic: Self-Sampling Opportunities to Accelerate the Elimination of Cervical Cancer

Ložar¹,

Nagvekar²,

Rohrer³

et al. 2021

IJWH

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The persisting burden of cervical cancer in underserved populations and low-resource regions worldwide, worsened by the onset of the COVID-19 pandemic, requires proactive strategies and expanded screening options to maintain and improve screening coverage and its effects on incidence and mortality from cervical cancer. Self-sampling as a screening strategy has unique advantages from both a public health and individual patient perspective. Some of the barriers to screening can be mitigated by self-sampling, and resources can be better allocated to patients at the highest risk of developing cervical cancer. This review summarizes the implementation options for self-sampling and associated challenges, evidence in support of self-sampling, the available devices, and opportunities for expansion beyond human papillomavirus testing.

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“…Self-sampling for HPV testing (HPVSS) is a process where a woman who wants to know whether she has a high-risk HPV infection uses a kit to collect a cervicovaginal sample from herself 12–14. HPVSS has been shown to increase the participation of women in CC screening programmes by reducing individual and health system-related barriers to screening particularly in low-resource settings 12 14. The lack of privacy, fear and shame of a pelvic examination, and long distances to health facilities have been cited as barriers to CC screening 8 12.…”

Section: Introductionmentioning

confidence: 99%

Human papillomavirus self-sampling for cervical cancer screening among women in sub-Saharan Africa: a scoping review protocol

et al. 2022

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IntroductionEvidence shows that women in sub-Saharan Africa have high rates of cervical cancer (CC) mortality compared with women in high-income countries. Effective screening programmes have significantly reduced the burden of CC in high-income countries. Self-sampling for human papillomavirus testing (HPVSS) has been reported to increase the participation and engagement of women in CC screening. Before HPVSS can be introduced for CC screening there is a need to establish its acceptability among end-users to ensure the increase in CC screening rates. Here, we outline a protocol for a scoping review aimed at mapping literature on the use and acceptability of HPVSS for screening CC in sub-Saharan Africa to reveal gaps to guide future research and practice.MethodThe scoping review protocol was developed according to Arksey and O’Malley and Levac et al, and guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. We will search Scopus, PubMed, Medline Ovid, Cochrane and Web of Science databases for evidence on the use and acceptability of HPVSS published between January 2011 and July 2021. We will also search grey literature in the form of dissertations/theses, conference proceedings, websites of international organisations such as the WHO, and relevant government reports reporting evidence on HPVSS programmes for screening CC among women in sub-Saharan Africa.Ethics and disseminationNo ethical approval is needed for the study as it will not include animals or human participants. The results of the proposed scoping review will be disseminated electronically in peer-reviewed journals, in print and through conference presentations.

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Why Consider Self-Sampling for Cervical Cancer Screening in Low- and Middle-Income Countries?

Cited by 15 publications

References 23 publications

High-risk human papillomavirus detection in self-collected vaginal samples compared with healthcare worker collected cervical samples among women attending gynecology clinics at a tertiary hospital in Pretoria, South Africa

High-risk human papillomavirus detection in self-collected vaginal samples compared with healthcare worker collected cervical samples among women attending gynecology clinics at a tertiary hospital in Pretoria, South Africa

Cervical Cancer Screening Postpandemic: Self-Sampling Opportunities to Accelerate the Elimination of Cervical Cancer

Human papillomavirus self-sampling for cervical cancer screening among women in sub-Saharan Africa: a scoping review protocol

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