Autor: |
Dorthe Ørnskov, Kirsten Jochumsen, Pernille Husted Steiner, Ivan Moulun Grunnet, Annemette Wildfang Lykkebo, Marianne Waldstrøm |
Jazyk: |
angličtina |
Rok vydání: |
2021 |
Předmět: |
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Zdroj: |
BMJ Open, Vol 11, Iss 3 (2021) |
Druh dokumentu: |
article |
ISSN: |
2044-6055 |
DOI: |
10.1136/bmjopen-2020-041512 |
Popis: |
Objectives To increase effectiveness of the cervical cancer screening program, self-sampling can be an option. Both self-collected vaginal samples (SCV) and urine samples may be useful alternatives to clinician-taken cervical samples (CS).Design Cross-sectional study.Setting Colposcopy clinic.Participants Women (n=305) referred to colposcopy after abnormal cervical screening result or conditions like postcoital bleeding.Intervention All women self-collected a urine and a vaginal sample prior to colposcopy, where a CS and biopsies were taken. All samples were tested for high-risk human papillomavirus (HPV) using the Cobas HPV assay. The gold standard was histology diagnoses (CIN2+/CIN3+) from biopsies obtained at the same examination.Primary outcome Absolute and relative sensitivity and specificity of HPV testing on SCV and urine to detect CIN2+/CIN3+ compared with the CS.Secondary outcome The acceptability by women of self-sampling.Results Both the vaginal and urine sample were comparable to the CS in identifying severe intraepithelial neoplasia (CIN2+/CIN3+). Absolute sensitivity ranged from 93% for urine samples to 96% for SCV for detecting CIN2+, which is comparable to the sensitivity of CS (overlapping 95% CI).The relative sensitivity for detecting CIN2+ was 1.00 (95% CI 0.96 to 1.04) for SCV and 0.96 (95% CI 0.91 to 1.03) for urine samples. At CIN3+, the relative sensitivity was 1.00 (95% CI 0.96 to 1.08) and 0.97 (95% CI 0.89 to 1.07) for SCV and urine samples, respectively. There were no statistical differences between the self-collected samples and the CS (McNemar’s test >0.05). The relative specificity was also similar (1.03 (95% CI 0.95 to 1.12) for SCV and 0.98 (95% CI 0.89 to 1.09) for urine samples) (McNemar’s test >0.05).The acceptability of self-sampling was evaluated by questionnaire. The women found the instructions on sample collection easy to understand and were positive about self-sampling with a preference for the urine sample.Conclusion Self-sampling by SCV and urine is a clinically safe alternative to CS with a high degree of acceptability. |
Databáze: |
Directory of Open Access Journals |
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