Sociodemographic Characteristics and Screening Outcomes of Women Preferring Self-Sampling in the Dutch Cervical Cancer Screening Programme: A Population-Based Study.

Autor:	Aitken CA; University Medical Center Rotterdam, Erasmus MC, Department of Public Health, Rotterdam, the Netherlands.; Department of Pathology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands., Inturrisi F; Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, Amsterdam, the Netherlands.; Amsterdam Public Health, Methodology, Amsterdam, the Netherlands., Kaljouw S; University Medical Center Rotterdam, Erasmus MC, Department of Public Health, Rotterdam, the Netherlands., Nieboer D; University Medical Center Rotterdam, Erasmus MC, Department of Public Health, Rotterdam, the Netherlands., Siebers AG; The Nationwide Network and Registry of Histo-and Cytopathology in the Netherlands (PALGA Foundation), Houten, the Netherlands., Melchers WJG; Radboud University Medical Center, Medical Microbiology, Nijmegen, the Netherlands., van den Brule AJC; Jeroen Bosch Hospital, Pathologie-DNA, 's-Hertogenbosch, the Netherlands., Molijn A; DDL Diagnostic Laboratory, NMDL-LCPL, Rijswijk, the Netherlands., Hinrichs JWJ; Symbiant Pathology Expert Centre Hoorn, Hoorn, the Netherlands.; Pathology, University Medical Center Utrecht, Utrecht, the Netherlands., Niesters HGM; Division of Clinical Virology, Department of Medical Microbiology, The University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., van Kemenade FJ; Department of Pathology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands., Berkhof J; Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, Amsterdam, the Netherlands.; Amsterdam Public Health, Methodology, Amsterdam, the Netherlands., de Kok IMCM; University Medical Center Rotterdam, Erasmus MC, Department of Public Health, Rotterdam, the Netherlands.
Jazyk:	angličtina
Zdroj:	Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology [Cancer Epidemiol Biomarkers Prev] 2023 Feb 06; Vol. 32 (2), pp. 183-192.
DOI:	10.1158/1055-9965.EPI-22-0712
Abstrakt:	Background: In the Netherlands, lower high-risk human papillomavirus (hrHPV) positivity but higher cervical intraepithelial neoplasia (CIN) 2+ detection were found in self-collected compared with clinician-collected samples. To investigate the possible reason for these differences, we compared sociodemographic and screening characteristics of women and related these to screening outcomes. Methods: We extracted data from PALGA on all primary hrHPV screens and associated follow-up tests for 857,866 screened women, invited in 2017 and 2018. We linked these data with sociodemographic data from Statistics Netherlands. Logistic regression was performed for hrHPV positivity and CIN 2+/3+ detection. Results: Out of the 857,866 women, 6.8% chose to use a self-sampling device. A higher proportion of self-sampling users was ages 30 to 35 years, was not previously screened, was living in a one-person household, or was the breadwinner in the household. After adjustment for these factors self-sampling had lower hrHPV positivity (aOR, 0.65; 95% CI, 0.63-0.68)) as compared with clinician-collected sampling, as well as lower odds of CIN 2+ (aOR, 0.76; 95% CI, 0.70-0.82) and CIN 3+ (aOR, 0.86; 95% CI, 0.78-0.95) detection. Conclusions: It is likely that the observed differences between the two sampling methods are not only related to sociodemographic differences, but related to differences in screening test accuracy and/or background risk. Impact: Self-sampling can be used for targeting underscreened women, as a more convenient screening tool. Further investigation is required to evaluate how to implement self-sampling, when it is used as a primary instrument in routine screening. See related commentary by Arbyn et al., p. 159. (©2022 The Authors; Published by the American Association for Cancer Research.)
Databáze:	MEDLINE
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