Addressing COVID-19 Screening Delays: The Impact of HPV Self-Sampling on Non-Attenders in a Cervical Cancer Screening Program.

IF 4.5 2区 医学 Q1 ONCOLOGY
Cancers Pub Date : 2024-12-05 DOI:10.3390/cancers16234071
Angela Chiereghin, Lorenzo Pizzi, Carolina Buriani, Tiziana Sanna, Andrea Amico, Lorena Squillace, Elena Molinari, Maria Siponta Florean, Giovanni Lanza, Francesca Mezzetti
{"title":"Addressing COVID-19 Screening Delays: The Impact of HPV Self-Sampling on Non-Attenders in a Cervical Cancer Screening Program.","authors":"Angela Chiereghin, Lorenzo Pizzi, Carolina Buriani, Tiziana Sanna, Andrea Amico, Lorena Squillace, Elena Molinari, Maria Siponta Florean, Giovanni Lanza, Francesca Mezzetti","doi":"10.3390/cancers16234071","DOIUrl":null,"url":null,"abstract":"<p><p><b>Background/Objectives</b>: Self-sampling is recognized as a viable alternative to clinician-sampling for HPV primary screening. This study aimed to assess, within an Italian organized cervical cancer screening program, the acceptance and ease of use of self-sampling and the adherence to follow-up. The prevalences of HPV infection, cervical dysplasia, and cancer were contextually evaluated. <b>Methods</b>: Electronic records of 19,327 women, 30-64 years-old, residing within the Bologna Local Health Authority territory, who were offered self-sampling as an alternative to clinician-sampling, were retrospectively reviewed. They had never or irregularly attended and were overdue for a screening invitation due to the COVID-19 pandemic. An opt-in approach was adopted, involving local pharmacies for kit delivery and sample collection. Initially, HPV-positive results led to direct referral to colposcopy; later, cytological triage on clinician-samples was provided. <b>Results</b>: Self-sampling reached over twice as many women (11.5%) compared to historical clinician-sampling alone (<5%), showing high acceptance. Additionally, a high screening completion level was observed, with 79.5% of self-samples returned to pharmacies. A low percentage of self-samples resulted in inadequate results (1.1%), suggesting the method's ease of use. HPV-positivity was 13.1%, higher than the 9.9% recorded in the ordinary screening population in 2019 (<i>p</i> < 0.001), the last year before the pandemic. Compliance to both immediate colposcopy and cytology triage exceeded 90% (<i>p</i> = 0.675). The rate of cervical adenocarcinoma was twice as high as in the routinely screened population in 2019 (0.9‱ versus 0.4‱). Finally, 6% of women opted for clinician appointments. <b>Conclusions</b>: Self-sampling proved to be an easy-to-use and effective tool for reaching non-attenders, who are at high risk of cancer. Cytology triage on clinician-samples did not negatively impact follow-up adherence. It seems appropriate to maintain a clinician-collection option even among non-attenders.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"16 23","pages":""},"PeriodicalIF":4.5000,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11640733/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancers","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3390/cancers16234071","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background/Objectives: Self-sampling is recognized as a viable alternative to clinician-sampling for HPV primary screening. This study aimed to assess, within an Italian organized cervical cancer screening program, the acceptance and ease of use of self-sampling and the adherence to follow-up. The prevalences of HPV infection, cervical dysplasia, and cancer were contextually evaluated. Methods: Electronic records of 19,327 women, 30-64 years-old, residing within the Bologna Local Health Authority territory, who were offered self-sampling as an alternative to clinician-sampling, were retrospectively reviewed. They had never or irregularly attended and were overdue for a screening invitation due to the COVID-19 pandemic. An opt-in approach was adopted, involving local pharmacies for kit delivery and sample collection. Initially, HPV-positive results led to direct referral to colposcopy; later, cytological triage on clinician-samples was provided. Results: Self-sampling reached over twice as many women (11.5%) compared to historical clinician-sampling alone (<5%), showing high acceptance. Additionally, a high screening completion level was observed, with 79.5% of self-samples returned to pharmacies. A low percentage of self-samples resulted in inadequate results (1.1%), suggesting the method's ease of use. HPV-positivity was 13.1%, higher than the 9.9% recorded in the ordinary screening population in 2019 (p < 0.001), the last year before the pandemic. Compliance to both immediate colposcopy and cytology triage exceeded 90% (p = 0.675). The rate of cervical adenocarcinoma was twice as high as in the routinely screened population in 2019 (0.9‱ versus 0.4‱). Finally, 6% of women opted for clinician appointments. Conclusions: Self-sampling proved to be an easy-to-use and effective tool for reaching non-attenders, who are at high risk of cancer. Cytology triage on clinician-samples did not negatively impact follow-up adherence. It seems appropriate to maintain a clinician-collection option even among non-attenders.

解决COVID-19筛查延迟:HPV自采样对未参加宫颈癌筛查计划的影响
背景/目的:自我抽样被认为是替代临床抽样进行HPV初级筛查的可行方法。本研究旨在评估,在意大利有组织的宫颈癌筛查项目中,自我抽样的接受度和易用性以及随访的依从性。对HPV感染、宫颈发育不良和癌症的患病率进行了综合评估。方法:回顾性回顾了19327名居住在博洛尼亚地方卫生当局辖区的30-64岁妇女的电子记录,这些妇女采用自我抽样作为临床抽样的替代方法。他们从来没有或不定期参加,而且由于新冠肺炎大流行而逾期未获筛查邀请。采用了选择加入的方法,让当地药房提供试剂盒和收集样本。最初,hpv阳性结果导致直接转介到阴道镜检查;随后,对临床样本进行细胞学分类。结果:在大流行前的最后一年,自我抽样的妇女人数(11.5%)是单独进行历史临床抽样的两倍多(p < 0.001)。即刻阴道镜检查和细胞学分诊的依从性均超过90% (p = 0.675)。2019年,宫颈腺癌的发病率是常规筛查人群的两倍(0.9‰对0.4‰)。最后,6%的女性选择预约临床医生。结论:自我抽样被证明是一种易于使用和有效的工具,可以接触到癌症高风险的非参与者。临床样本的细胞学分类对随访依从性没有负面影响。即使在非参与者中,保持临床收集选项似乎也是合适的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Cancers
Cancers Medicine-Oncology
CiteScore
8.00
自引率
9.60%
发文量
5371
审稿时长
18.07 days
期刊介绍: Cancers (ISSN 2072-6694) is an international, peer-reviewed open access journal on oncology. It publishes reviews, regular research papers and short communications. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信