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Aimagambetova G, Atageldiyeva K, Marat A, Suleimenova A, Issa T, Raman S, Huang T, Ashimkhanova A, Aron S, Dongo A, Iztleuov Y, Shamkeeva S, Azizan A. Comparison of diagnostic accuracy and acceptability of self-sampling devices for human Papillomavirus detection: A systematic review. Prev Med Rep 2024; 38:102590. [PMID: 38283967 PMCID: PMC10821625 DOI: 10.1016/j.pmedr.2024.102590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/28/2023] [Accepted: 01/02/2024] [Indexed: 01/30/2024] Open
Abstract
Objective Cervical cancer screening coverage remains low in many countries worldwide. Self-sampling approach for cervical cancer screening has a good potential to improve the screening coverage. This study aims to compare different types of HPV self-sampling devices for cervical cancer screening to identify the most accurate and acceptable device(s). Methods A systematic review was performed on data extracted from all studies specific to HPV self-sampling devices by searching relevant articles in PubMed, Google Scholar, Scopus, Web of Science, ScienceDirect, Cochrane Library, and EBSCO published from 2013 to October 2023. The study was registered in PROSPERO (CRD42022375682). Results Overall, 70 papers met the eligibility criteria for this systematic review and were included in the analysis: 22 studies reported self-sampling devices diagnostic accuracy, 32 studies reported self-sampling devices acceptability and 16 studies reported both (accuracy and acceptability). The most popular self-sampling devices were Evalyn Brush, FLOQ Swab, Cervex-Brush, and Delphi Screener. Out of overall 38 studies analyzing self-sampling devices' diagnostic accuracy, 94.7% of studies reported that self-collected specimens provided sensitivity and specificity comparable with clinician-collected samples; acceptability of Evalyn Brush, FLOQ Swab, Delphi Screener, and Colli-Pee, varied between 84.2% and 100%. Conclusion The self-sampling approach has a good potential to increase cervical cancer screening coverage. Evalyn Brush, Cervex-Brush, FLOQ Swab, and Delphi Screener self-sampling devices for HPV detection were the most commonly utilized and found to be the most accurate, and patient-acceptable. HPV detection accuracy using these self-sampling devices had no significant difference compared to the sampling performed by healthcare providers.
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Affiliation(s)
- Gulzhanat Aimagambetova
- Department of Surgery, School of Medicine, Nazarbayev University, 010000, Astana, Kazakhstan
| | - Kuralay Atageldiyeva
- Department of Medicine, School of Medicine, Nazarbayev University, 010000, Astana, Kazakhstan
- Clinical Academic Department of Internal Medicine, CF “University Medical Center”, 10000 Astana, Kazakhstan
| | - Aizada Marat
- Department of Obstetrics and Gynecology #1, NJSC “Astana Medical University”, 010000, Astana, Kazakhstan
| | - Assem Suleimenova
- Kazakh National Institute of Oncology and Radiology, Almaty, Kazakhstan
| | - Torgyn Issa
- School of Medicine, Nazarbayev University, 010000, Astana, Kazakhstan
| | - Sarina Raman
- College of Osteopathic Medicine, Touro University Nevada, Henderson, Nevada, USA
| | - Timothy Huang
- College of Osteopathic Medicine, Touro University Nevada, Henderson, Nevada, USA
| | - Ayimkul Ashimkhanova
- Department of Medicine, School of Medicine, Nazarbayev University, 010000, Astana, Kazakhstan
- Department of Clinical Medicine, School of Medicine, Al Farabi University, Almaty, Kazakhstan
| | - Saida Aron
- School of Medicine, Nazarbayev University, 010000, Astana, Kazakhstan
| | - Andrew Dongo
- College of Osteopathic Medicine, Touro University Nevada, Henderson, Nevada, USA
| | - Yerbolat Iztleuov
- Medical Center, Marat Ospanov West-Kazakhstan Medical University, 030000, Aktobe, Kazakhstan
| | - Saykal Shamkeeva
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Leipzig University Hospital, 04103, Leipzig, Germany
| | - Azliyati Azizan
- College of Osteopathic Medicine, Touro University Nevada, Henderson, Nevada, USA
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Addo-Lartey AA, Bonful HA, Sefenu RS, Abagre TA, Asamoah A, Bandoh DA, Awua AK, Adu-Aryee NA, Dedey F, Adanu RMK, Okuyemi KS. Effectiveness of a culturally tailored text messaging program for promoting cervical cancer screening in accra, Ghana: a quasi-experimental trial. BMC Womens Health 2024; 24:22. [PMID: 38172883 PMCID: PMC10765844 DOI: 10.1186/s12905-023-02867-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 12/25/2023] [Indexed: 01/05/2024] Open
Abstract
INTRODUCTION Despite breakthroughs in cervical cancer detection, resource-constrained countries continue to have a disproportionately high incidence and death rate. Mhealth has been identified as an important tool for increasing cervical cancer screening rates in Sub-Saharan Africa. We determined whether sending Ghanaian women culturally tailored one-way mobile phone SMS text messages about cervical cancer would encourage the uptake of the human papillomavirus (HPV) test. METHODS From August to November 2016, 88 women aged 18 to 39 living or working in an urban community (Accra, Ghana) participated in a quasi-experimental study. For 8 weeks, 32 SMS messages regarding cervical cancer were developed and sent to the personal phones of intervention arm participants (n = 42). Women in the control group (n = 46) received SMS texts with general health and lifestyle advice. Fischer's exact tests were performed to assess cervical cancer screening uptake and associated reasons for non-uptake between the intervention and control groups (p < 0.05). RESULTS At the baseline, women differed in terms of ethnicity and wealth. After the intervention, participants' self-reported risk factors for cervical cancer, such as early menarche, usual source of medical treatment, family history of cancer, smoking, and alcohol history, changed. None of the women in the intervention group sought cervical cancer screening after the intervention, but only one (2.2%) of the control arm participants did. Almost all the women (> 95%) agreed that an HPV test was essential and that regular healthcare check-ups could help prevent cervical cancer. Some women believed that avoiding particular foods could help prevent cervical cancer (23.8% intervention vs. 58.7% control, p < 0.001). Time constraints and out-of-pocket expenses were significant barriers to cervical cancer screening. CONCLUSION A one-way SMS delivered to urban women did not increase cervical cancer screening attendance. The time spent in screening facilities and the lack of coverage by the National Health Insurance Scheme limited screening uptake. We urge for the establishment of screening centers in all healthcare facilities, as well as the inclusion of cervical cancer screening in healthcare programs through cost-sharing.
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Affiliation(s)
| | - Harriet Affran Bonful
- Department of Epidemiology and Disease Control, University of Ghana School of Public Health, Accra, Ghana.
| | - Ransford Selasi Sefenu
- Department of Epidemiology and Disease Control, University of Ghana School of Public Health, Accra, Ghana
| | - Timothy Agandah Abagre
- Department of Epidemiology and Disease Control, University of Ghana School of Public Health, Accra, Ghana
| | - Alexander Asamoah
- Department of Epidemiology and Disease Control, University of Ghana School of Public Health, Accra, Ghana
| | - Delia Akosua Bandoh
- Department of Epidemiology and Disease Control, University of Ghana School of Public Health, Accra, Ghana
| | - Adolf Kofi Awua
- Cellular and Clinical Research Center, Radiological and Medical Sciences Research Institute, Ghana Atomic Energy Commission. Kwabenya, Accra, Ghana
| | - Nii Armah Adu-Aryee
- Department of Surgery, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
| | - Florence Dedey
- Department of Surgery, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
| | - Richard Mawuena Kofi Adanu
- Department of Population and Family Health, University of Ghana School of Public Health to Ghana College of Physicians and Surgeons, Accra, Ghana
| | - Kolawole Stephen Okuyemi
- Department of Family and Preventive Medicine, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, USA
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Dzobo M, Dzinamarira T, Maluleke K, Jaya ZN, Kgarosi K, Mashamba-Thompson TP. Mapping evidence on the acceptability of human papillomavirus self-sampling for cervical cancer screening among women in sub-Saharan Africa: a scoping review. BMJ Open 2023; 13:e062090. [PMID: 37085299 PMCID: PMC10124230 DOI: 10.1136/bmjopen-2022-062090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/23/2023] Open
Abstract
OBJECTIVES The objective of this scoping review was to map evidence on the acceptability of self-sampling for human papillomavirus testing (HPVSS) for cervical cancer screening among women in the sub-Saharan Africa region. DESIGN Scoping review. METHODS Using Arksey and O'Malley's framework, we searched Scopus, PubMed, Medline Ovid, Cochrane and Web of Science databases for evidence on the acceptability of HPVSS among women aged 25 years and older published between January 2011 and July 2021. We included studies that reported evidence on the acceptability of HPVSS for cervical cancer screening. Review articles and protocols were excluded. We also searched for evidence from grey literature sources such as dissertations/theses, conference proceedings, websites of international organisations such as WHO and relevant government reports. Two reviewers independently performed the extraction using a pre-designed Excel spreadsheet and emerging themes were narratively summarised. RESULTS The initial search retrieved 1018 articles. Of these, 19 articles were eligible and included in the review. The following themes emerged from the included articles: acceptability of HPVSS; lack of self-efficacy to perform HPVSS, complications when performing HPVSS, preferences for provider sampling or assistance; setting of HPVSS; HPVSS by vulnerable populations. CONCLUSION Evidence shows that HPVSS is highly acceptable for cervical cancer screening in sub-Saharan Africa. Further research exploring the acceptability of HPVSS among women residing in rural areas is required, as well as studies to determine women's preferences for HPVSS intervention including the preferred type of sampling devices. Knowledge on the acceptability and preferences for HPVSS is important in designing women-centred interventions that have the potential to increase screening coverage and participation in cervical cancer screening programmes.
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Affiliation(s)
- Mathias Dzobo
- School of Health Systems and Public Health, University of Pretoria Faculty of Health Sciences, Pretoria, South Africa
| | - Tafadzwa Dzinamarira
- School of Health Systems and Public Health, University of Pretoria Faculty of Health Sciences, Pretoria, South Africa
| | - Kuhlula Maluleke
- School of Health Systems and Public Health, University of Pretoria Faculty of Health Sciences, Pretoria, South Africa
| | - Ziningi Nobuhle Jaya
- School of Health Systems and Public Health, University of Pretoria Faculty of Health Sciences, Pretoria, South Africa
| | - Kabelo Kgarosi
- Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Jaya ZN, Mapanga W, van Niekerk B, Dlangalala T, Kgarosi K, Dzobo M, Mulqueeny D, Mashamba-thompson TP. Mapping Evidence of Self-Sampling to Diagnose Sexually Transmitted Infections in Women: A Scoping Review. Diagnostics (Basel) 2022; 12:1803. [PMID: 35892514 PMCID: PMC9331851 DOI: 10.3390/diagnostics12081803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/22/2022] [Accepted: 06/26/2022] [Indexed: 12/04/2022] Open
Abstract
Background: Sexually transmitted infections (STIs) are a major global healthcare burden, disproportionately affecting women. Self-sampling interventions for diagnostic purposes have the potential to improve STI healthcare management and expand STI services. However, there is currently no published evidence of the global use of self-sampling interventions to diagnose STIs in women. The main aim of this scoping review was to map evidence on the use of self-sampling interventions to diagnose STIs in women. Methodology: The methodology of this scoping review was guided by Arksey and O’Malley and Levac. A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, Medline (EBSCO), ProQuest, and Cochrane. For grey literature, a search was conducted in Open Grey, World Health Organization, Google, and conference proceedings and dissertations. All search results were screened and assessed for eligibility. Thereafter data from eligible studies was extracted and analysed. The quality of these studies was appraised using the Mixed Methods Appraisal Tool 2018 version. Results: A total of 770 articles were retrieved from databases and grey literature sources. A total of 44 studies were eligible for data extraction following title, abstract and full-text screening. Of the included studies, 63% presented evidence of research conducted in high-income countries and 37% presented evidence in low- and middle-income countries. Studies presented evidence on the following: feasibility of self-sampling in remote areas; acceptance and ease of use of self-sampling interventions; types of self-sampled specimens; pooled samples for diagnosing STIs; laboratory diagnostic assays for STI using self-sampled specimens; and self-testing of self-sampled specimens. Conclusions: Self-sampling interventions are feasible and easy to use and, therefore, can improve STI management and treatment in women across various age groups and various access levels to good-quality healthcare. Despite this, there is a lack of evidence of self-sampling interventions designed according to user preferences. We recommend studies to collaborate with women to co-develop user-friendly self-sampling interventions to diagnose STIs in women.
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Rikhotso RR, Mitchell EM, Wilson DT, Doede A, Matume ND, Bessong PO. Prevalence and distribution of selected cervical human papillomavirus types in HIV infected and HIV uninfected women in South Africa, 1989-2021: A narrative review. S Afr J Infect Dis 2022; 37:363. [PMID: 35815224 PMCID: PMC9257898 DOI: 10.4102/sajid.v37i1.363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 03/10/2022] [Indexed: 11/17/2022] Open
Abstract
Background Human papillomavirus infection, a causative agent of cervical cancer, is of great concern, more so in populations with high HIV prevalence, such as South Africa. Aim This review aimed to examine the prevalence and distribution of selected cervical human papillomavirus (HPV) types in HIV infected and HIV uninfected women in South Africa. Methods PubMed and Web of Science databases were searched using key words. For data integrity, data was assessed by two authors independently. The study inclusion criteria comprised records on cervical HPV, HPV genotyping and HPV type distribution among South African women. Statistical analysis was performed using Social Science Statistics. Results Sixty-nine articles met the inclusion criteria for analysis. Data on cervical HPV prevalence and type distribution was available only for five of the nine provinces of South Africa. Only 4/69 studies used sequencing as an approach to identify HPV types. In a general population, HPV type 16 was the most frequent (8.80%), followed by types 35 (4.86%), 18 (4.14%), 58 and 52 with the frequency of 3.65% and 3.62%, respectively. Furthermore, the least frequent type was HPV 70 (0.74%). Both HIV infected and HIV uninfected populations had a higher prevalence of high-risk human papillomavirus (hrHPV) types 16, 18 and 35 than other HPV types; while HPV types 6, 11 and 70 were the least frequent types from these populations. Lastly, HPV 16 was the most predominant type among women with normal (2.03%) and abnormal cervical cytology (6.60%). Conclusion Expanding on HPV genotyping will improve the knowledge in patterns of HPV type distribution in South Africa that will further help in decision making to improve current diagnostics, and future vaccine development and assessment.
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Affiliation(s)
- Rixongile R Rikhotso
- Department of Biochemistry and Microbiology, Faculty of Science, Engineering and Agriculture, University of Venda, Thohoyandou, South Africa
| | - Emma M Mitchell
- Department of Family, Community and Mental Health Systems, School of Nursing, University of Virginia, Charlottesville, United States of America
| | - Daniel T Wilson
- Claude Moore Health Sciences Library, School of Nursing, University of Virginia, Charlottesville, United States of America
| | - Aubrey Doede
- Department of Family Medicine and Public Health, University of California San Diego, California, United States of America
| | - Nontokozo D Matume
- HIV/AIDS & Global Health Research Programme, University of Venda, Thohoyandou, South Africa
| | - Pascal O Bessong
- HIV/AIDS & Global Health Research Programme, University of Venda, Thohoyandou, South Africa
- Center for Global Health Equity, School of Medicine, University of Virginia, Charlottesville, Virginia, United States of America
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Avian A, Clemente N, Mauro E, Isidoro E, Di Napoli M, Dudine S, Del Fabro A, Morini S, Perin T, Giudici F, Cammisuli T, Foschi N, Mocenigo M, Montrone M, Modena C, Polenghi M, Puzzi L, Tomaic V, Valenti G, Sola R, Zanolla S, Vogrig E, Riva E, Angeletti S, Ciccozzi M, Castriciano S, Pachetti M, Petti M, Centonze S, Gerin D, Banks L, Marini B, Canzonieri V, Sopracordevole F, Zanconati F, Ippodrino R. Clinical validation of full HR-HPV genotyping HPV Selfy assay according to the international guidelines for HPV test requirements for cervical cancer screening on clinician-collected and self-collected samples. J Transl Med 2022; 20:231. [PMID: 35581584 PMCID: PMC9115952 DOI: 10.1186/s12967-022-03383-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/07/2022] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND According to international guidelines, Human Papillomavirus (HPV) DNA tests represent a valid alternative to Pap Test for primary cervical cancer screening, provided that they guarantee balanced clinical sensitivity and specificity for cervical intraepithelial neoplasia grade 2 or more (CIN2+) lesions. The study aimed to assess whether HPV Selfy (Ulisse BioMed - Trieste, Italy), a full-genotyping HPV DNA test that detects and differentiates 14 high-risk HPV (HR-HPV) types, meets the criteria for primary cervical cancer screening described in the international guidelines, on clinician-collected as well as on self-collected samples. METHODS For each participant woman, consecutively referring to Azienda Sanitaria Universitaria Giuliano Isontina (Trieste, Italy) and CRO-National Cancer Institute (Aviano, Italy) for the cervical cancer screening program, the following samples were tested: (a) a clinician-collected cervical specimen, analyzed with the reference test (Hybrid Capture®2 test, HC2) and HPV Selfy; and (b) a self-collected vaginal sample, analyzed with HPV Selfy. Enrolled women were also asked to fulfill a questionnaire about self-sampling acceptability. As required by guidelines, a non-inferiority test was conducted to compare the clinical performance of the test under evaluation with its reference test. RESULTS HPV Selfy clinical sensitivity and specificity resulted non-inferior to those of HC2. By analysis of a total of 889 cervical liquid-based cytology samples from a screening population, of which 98 were from women with CIN2+, HPV Selfy showed relative sensitivity and specificity for CIN2+ of 0.98 and 1.00 respectively (non-inferiority score test: P = 0.01747 and P = 0.00414, respectively); the test reached adequate intra- and inter-laboratory reproducibility. Moreover, we demonstrated that the performance of HPV Selfy on self-collected vaginal samples was non-inferior to the performance obtained on clinician-collected cervical specimen (0.92 relative sensitivity and 0.97 relative specificity). Finally, through HPV Selfy genotyping, we were able to describe HPV types prevalence in the study population. CONCLUSIONS HPV Selfy fulfills all the requirements of the international Meijer's guidelines and has been clinically validated for primary cervical cancer screening purposes. Moreover, HPV Selfy has also been validated for self-sampling according to VALHUDES guidelines. Therefore, at date, HPV Selfy is the only full-genotyping test validated both for screening purposes and for self-sampling. Trial registration ASUGI Trieste n. 16008/2018; CRO Aviano n.17149/2018.
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Affiliation(s)
- Alice Avian
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy ,grid.438882.d0000 0001 0212 6916Molecular Genetics and Biotechnology PhD Study Programme, University of Nova Gorica, Nova Gorica, Slovenia
| | - Nicolò Clemente
- grid.418321.d0000 0004 1757 9741Ginecologia Oncologica, IRCCS - Centro Di Riferimento Oncologico (CRO) (Istituto Nazionale Tumori – National Cancer Institute), Aviano, Italy
| | - Elisabetta Mauro
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Erica Isidoro
- grid.413694.dAzienda Sanitaria Universitaria Giuliano Isontina UCO/SC Anatomia e Istologia Patologica, Cattinara Hospital, Trieste, Italy
| | - Michela Di Napoli
- grid.413694.dAzienda Sanitaria Universitaria Giuliano Isontina UCO/SC Anatomia e Istologia Patologica, Cattinara Hospital, Trieste, Italy
| | - Sandra Dudine
- grid.413694.dAzienda Sanitaria Universitaria Giuliano Isontina UCO/SC Anatomia e Istologia Patologica, Cattinara Hospital, Trieste, Italy
| | - Anna Del Fabro
- grid.418321.d0000 0004 1757 9741Ginecologia Oncologica, IRCCS - Centro Di Riferimento Oncologico (CRO) (Istituto Nazionale Tumori – National Cancer Institute), Aviano, Italy
| | - Stefano Morini
- grid.418321.d0000 0004 1757 9741Ginecologia Oncologica, IRCCS - Centro Di Riferimento Oncologico (CRO) (Istituto Nazionale Tumori – National Cancer Institute), Aviano, Italy
| | - Tiziana Perin
- grid.418321.d0000 0004 1757 9741Ginecologia Oncologica, IRCCS - Centro Di Riferimento Oncologico (CRO) (Istituto Nazionale Tumori – National Cancer Institute), Aviano, Italy
| | - Fabiola Giudici
- grid.5133.40000 0001 1941 4308Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Tamara Cammisuli
- grid.418321.d0000 0004 1757 9741Anatomia Patologica, IRCCS – CRO (Istituto Nazionale Tumori - National Cancer Institute), Aviano, Italy
| | - Nicola Foschi
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Marco Mocenigo
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy ,grid.438882.d0000 0001 0212 6916Molecular Genetics and Biotechnology PhD Study Programme, University of Nova Gorica, Nova Gorica, Slovenia
| | - Michele Montrone
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Chiara Modena
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Martina Polenghi
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Luca Puzzi
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Vjekoslav Tomaic
- grid.4905.80000 0004 0635 7705Institut Ruđer Bošković, Zagreb, Croatia
| | - Giulio Valenti
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Riccardo Sola
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Shivani Zanolla
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Enea Vogrig
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Elisabetta Riva
- grid.488514.40000000417684285Policlinico Universitario Campus Biomedico, Rome, Italy
| | - Silvia Angeletti
- grid.488514.40000000417684285Policlinico Universitario Campus Biomedico, Rome, Italy
| | - Massimo Ciccozzi
- grid.488514.40000000417684285Policlinico Universitario Campus Biomedico, Rome, Italy
| | | | - Maria Pachetti
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy ,grid.418712.90000 0004 1760 7415Institute of Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Matteo Petti
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Sandro Centonze
- Clinical Research Unit, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Daniela Gerin
- Cervical Cancer Screening Coordination Unit, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Lawrence Banks
- grid.425196.d0000 0004 1759 4810International Centre for Genetic Engineering and Biotechnology, Trieste, Italy
| | - Bruna Marini
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Vincenzo Canzonieri
- grid.5133.40000 0001 1941 4308Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy ,grid.418321.d0000 0004 1757 9741Anatomia Patologica, IRCCS – CRO (Istituto Nazionale Tumori - National Cancer Institute), Aviano, Italy
| | - Francesco Sopracordevole
- grid.418321.d0000 0004 1757 9741Ginecologia Oncologica, IRCCS - Centro Di Riferimento Oncologico (CRO) (Istituto Nazionale Tumori – National Cancer Institute), Aviano, Italy
| | - Fabrizio Zanconati
- grid.413694.dAzienda Sanitaria Universitaria Giuliano Isontina UCO/SC Anatomia e Istologia Patologica, Cattinara Hospital, Trieste, Italy ,grid.5133.40000 0001 1941 4308Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Rudy Ippodrino
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy
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Tiiti TA, Mashishi TL, Nkwinika VV, Molefi KA, Benoy I, Bogers J, Selabe SG, Lebelo RL. Evaluation of ILEX SelfCerv for Detection of High-Risk Human Papillomavirus Infection in Gynecology Clinic Attendees at a Tertiary Hospital in South Africa. J Clin Med 2021; 10:jcm10214817. [PMID: 34768334 PMCID: PMC8584638 DOI: 10.3390/jcm10214817] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/14/2021] [Accepted: 10/15/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The SelfCerv Self-Collection Cervical Health Screening Kit (Ilex Medical Ltd., Johannesburg, South Africa) is an applicator tampon designed for self-collection of vaginal samples for the detection of human papillomavirus (HPV) deoxyribonucleic acid (DNA) and E6/E7 messenger ribonucleic acid (mRNA). The study aimed to evaluate the performance of the SelfCerv applicator tampon for the detection of hr-HPV for cervical cancer screening, and further to investigate women's experiences and preferences regarding self-sampling. METHODS Vaginal samples were collected from 527 gynecology clinic attendees aged ≥18 years at a tertiary hospital in Gauteng Province, South Africa. Self-samples were collected using the SelfCerv kit, followed by endocervical samples collected by a healthcare professional using Cervex-Brush® Combi. Participants completed a self-administered questionnaire on self-sampling experiences and preferences. Both samples were tested for 14 high-risk (hr) HPV types and E6/E7 mRNA using the Abbott RealTime HR-HPV and Aptima HR-HPV mRNA assays, respectively. RESULTS The overall agreement for hr-HPV typing between 527 paired samples was good (87.1%; κ =0.74) with high sensitivity (86.2%) and specificity (88.0%). HPV-16 (96.4%; κ = 0.83) had higher agreement rate than HPV-18 (96.8%; κ = 0.72) and the other 12 hr-HPVs (86.5%; κ = 0.72). Two hundred and eighty-five (285) sample pairs tested for E6/E7 mRNA showed fair agreement (70.2%; κ= 0.34). Furthermore, self-sampling was reported as comfortable (90.5%) and painless (86.7%), with 88.4% of women preferring self-collection. CONCLUSIONS Self-collected samples had good agreement with the healthcare professional-collected samples for the detection of hr-HPV DNA and the procedure was highly preferred by women. Self-sampling using SelfCerv can be used as an alternative to healthcare professional sampling in clinic-based routine cervical cancer screening.
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Affiliation(s)
- Teboho Amelia Tiiti
- Department of Virological Pathology, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa; (T.A.T.); (T.L.M.); (V.V.N.); (S.G.S.)
- Laboratory of Cell Biology and Histology, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerpen, Belgium; (I.B.); (J.B.)
| | - Tebogo Loraine Mashishi
- Department of Virological Pathology, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa; (T.A.T.); (T.L.M.); (V.V.N.); (S.G.S.)
| | - Varsetile Varster Nkwinika
- Department of Virological Pathology, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa; (T.A.T.); (T.L.M.); (V.V.N.); (S.G.S.)
- South African Vaccination and Immunization Centre, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa
| | - Kgotlaethata Aaron Molefi
- Department of Obstetrics and Gynaecology, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa;
| | - Ina Benoy
- Laboratory of Cell Biology and Histology, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerpen, Belgium; (I.B.); (J.B.)
- Algemeen Medisch Laboratorium (AML), Sonic Healthcare, 2020 Antwerpen, Belgium
| | - Johannes Bogers
- Laboratory of Cell Biology and Histology, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerpen, Belgium; (I.B.); (J.B.)
- Algemeen Medisch Laboratorium (AML), Sonic Healthcare, 2020 Antwerpen, Belgium
- Department of Anatomical Pathology, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa
| | - Selokela Gloria Selabe
- Department of Virological Pathology, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa; (T.A.T.); (T.L.M.); (V.V.N.); (S.G.S.)
- National Health Laboratory Service, Department of Virological Pathology, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa
| | - Ramokone Lisbeth Lebelo
- Department of Virological Pathology, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa; (T.A.T.); (T.L.M.); (V.V.N.); (S.G.S.)
- South African Vaccination and Immunization Centre, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa
- National Health Laboratory Service, Department of Virological Pathology, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa
- Correspondence: ; Tel.: +27-12521-3038
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Tesfahunei HA, Ghebreyesus MS, Assefa DG, Zeleke ED, Acam J, Joseph M, Getachew E, Kajogoo VD, Bekele D, Manyazewal T. Human papillomavirus self-sampling versus standard clinician-sampling for cervical cancer screening in sub-Saharan Africa: a systematic review and meta-analysis of randomized controlled trials. Infect Agent Cancer 2021; 16:43. [PMID: 34147103 PMCID: PMC8214270 DOI: 10.1186/s13027-021-00380-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/25/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) infection remains a major health threat in sub-Saharan Africa (SSA). HPV self-sampling could help find and treat cervical cancer at an early stage. We aimed to evaluate the effectiveness of HPV self-sampling over the standard health facility-based clinician-sampling for cervical cancer screening through a systematic review and meta-analysis of available randomized controlled trials. METHOD We searched PubMed, Cochrane Central Register of Controlled Trials, ClinicalTrial.gov, and the WHO Global Health Library for articles in SSA published as of 31 May 2020. We followed the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) 2015 guidelines for the design and reporting of the results. We included randomized control trials that compared HPV self-sampling with the standard of care. The primary endpoint was uptake of cervical cancer screening service. The secondary endpoints were linkage to care, acceptability, screening frequency, and adverse events. We used RevMan V.5.3 software for statistical analysis. We computed random-effect model to provide pooled estimates of available data and I-squared (I2) test to assess heterogeneity. RESULT Of 77 citations, we included four trials from Nigeria, Ethiopia, Kenya, and Uganda, encompassing 8200 participants with age ranging from 25 to 65 years. The pooled analysis showed significantly higher uptake of cervical cancer screening in women who used HPV self-sampling (risk ratio [RR] 1.72, 95% CI 1.58-1.87; p = 0.01), while this had a considerable heterogeneity as explained by subgroup analysis. Uptake was higher in women who were offered sampling kit at home or work (RR 2.05, 95% CI 1.80-2.33) and those who's kit was mailed to or invited to a nearby health center (RR 1.65, 95% CI 1.58-1.72, I2 = 0%) than those screened with the standard of care. There was no difference between the two groups in the rate of linkage to care of positive cases (RR 1.30, 95% CI 0.90-2.74, I2 = 91%). HPV self-sampling was acceptable and easy to use. None of the trials compared the frequency of screening or adverse events. CONCLUSION HPV self-sampling is an effective and feasible alternative to the standard health facility-based clinician-sampling for cervical cancer screening in SSA. It could improve the uptake of cervical cancer screening and harness the global strategy towards elimination of cervical cancer by 2030.
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Affiliation(s)
- Hanna Amanuel Tesfahunei
- Addis Ababa University, College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), P.O. Box 9086, Addis Ababa, Ethiopia
- Hager Biomedical Research Institute, Asmara, Eritrea
| | | | - Dawit Getachew Assefa
- Addis Ababa University, College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), P.O. Box 9086, Addis Ababa, Ethiopia
- Department of Nursing, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
| | - Eden Dagnachew Zeleke
- Addis Ababa University, College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), P.O. Box 9086, Addis Ababa, Ethiopia
- Department of Midwifery, College of Health Science, Bule-Hora University, Bule-Hora, Ethiopia
| | - Joan Acam
- Addis Ababa University, College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), P.O. Box 9086, Addis Ababa, Ethiopia
- Pope John’s Hospital Aber, Oyam District, Uganda
| | - Michele Joseph
- Addis Ababa University, College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), P.O. Box 9086, Addis Ababa, Ethiopia
| | - Emnet Getachew
- Addis Ababa University, College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), P.O. Box 9086, Addis Ababa, Ethiopia
- Arsi University, Asella, Ethiopia
| | - Violet Dismas Kajogoo
- Addis Ababa University, College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), P.O. Box 9086, Addis Ababa, Ethiopia
- Mafia District Hospital, Mafia Island, Tanzania
| | - Delayehu Bekele
- Addis Ababa University, College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), P.O. Box 9086, Addis Ababa, Ethiopia
- Department of Obstetrics and Gynecology, Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Tsegahun Manyazewal
- Addis Ababa University, College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), P.O. Box 9086, Addis Ababa, Ethiopia
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Nishimura H, Yeh PT, Oguntade H, Kennedy CE, Narasimhan M. HPV self-sampling for cervical cancer screening: a systematic review of values and preferences. BMJ Glob Health 2021; 6:e003743. [PMID: 34011537 PMCID: PMC8137189 DOI: 10.1136/bmjgh-2020-003743] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 03/31/2021] [Accepted: 04/26/2021] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION The WHO recommends human papillomavirus (HPV) cervical self-sampling as an additional screening method and HPV DNA testing as an effective approach for the early detection of cervical cancer for women aged ≥30 years. This systematic review assesses end user's values and preferences related to HPV self-sampling. METHODS We searched four electronic databases (PubMed, Cumulative Index to Nursing and Allied Health Literature, Latin American and Caribbean Health Sciences Literature and Embase) using search terms for HPV and self-sampling to identify articles meeting inclusion criteria. A standardised data extraction form was used to capture study setting, population, sample size and results related to values and preferences. RESULTS Of 1858 records retrieved, 72 studies among 52 114 participants published between 2002 and 2018 were included in this review. Almost all studies were cross-sectional surveys. Study populations included end users who were mainly adolescent girls and adult women. Ages ranged from 14 to 80 years. Most studies (57%) were conducted in high-income countries. Women generally found HPV self-sampling highly acceptable regardless of age, income or country of residence. Lack of self-confidence with collecting a reliable sample was the most commonly cited reason for preferring clinician-collected samples. Most women preferred home-based self-sampling to self-sampling at a clinic. The cervical swab was the most common and most accepted HPV DNA sampling device. CONCLUSIONS HPV self-sampling is generally a highly accepted method of cervical cancer screening for end users globally. End user preferences for self-sampling device, method and setting can inform the development of new and expanded interventions to increase HPV screening.
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Affiliation(s)
- Holly Nishimura
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ping Teresa Yeh
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Habibat Oguntade
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Caitlin E Kennedy
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Manjulaa Narasimhan
- Department of Sexual and Reproductive Health and Research, UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Geneva, Switzerland
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Dube Mandishora RS, Rounge TB, Fitzpatrick M, Christiansen IK, Ambur OH, Lagström S, Stray-Pedersen B, Tommasino M, Palefsky J, Chirenje ZM. Self-collected and clinician-collected anal swabs show modest agreement for HPV genotyping. PLoS One 2021; 16:e0250426. [PMID: 33901223 PMCID: PMC8075200 DOI: 10.1371/journal.pone.0250426] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 04/06/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND & AIM Women with HIV/HPV coinfection and cervical lesions are at increased risk of developing HPV related anal cancer. Self-collection of anal swabs may facilitate HPV molecular testing in anal cancer screening, especially in high-risk groups, and yet it is not adequately studied. We evaluated level of agreement between self-collected anal swabs (SCAS) and clinician-collected anal swabs (CCAS) when used for HPV genotyping. We also described the anal HPV genotype distribution and HIV/HPV coinfection. METHODS We performed a cross sectional study with participants from a visual-inspection-with-acetic-acid and cervicography (VIAC) clinic, in Harare, Zimbabwe. In a clinic setting, the women aged ≥18 years provided anal swabs in duplicate; first CCAS and then SCAS immediately after. HPV detection and genotyping were performed using next generation amplicon sequencing of a 450bp region of the HPV L1 gene. Level of agreement of HPV genotypes between CCAS and SCAS was calculated using the kappa statistic. McNemar tests were used to evaluate agreement in the proportion of genotypes detected by either method. RESULTS Three-hundred women provided 600 samples for HPV genotyping. HPV genotypes were detected in 25% of SCAS and in 22% of CCAS. The most common genotypes with CCAS were HPV52, HPV62 and HPV70 and with SCAS were HPV62, HPV44, HPV52, HPV53 and HPV68. Total HPV genotypes detected in CCAS were more than those detected in SCAS, 32 versus 27. The agreement of HPV genotypes between the two methods was 0.55 in kappa value (k). The test of proportions using McNemar gave a Chi-square value of 0.75 (p = 0.39). Multiple HPV infections were detected in 28/75 and 29/67 women for CCAS and SCAS respectively. CONCLUSIONS SCAS and CCAS anal swabs showed moderate agreement, with no statistically significant difference in the proportion of genotypes detected by either methods. Although the differences between the two methods were not statistically significant, CCAS detected more HPV genotypes than SCAS and more HPV infections were detected in SCAS than in CCAS. Our data suggest that self-collected anal swabs can be used as an alternative to clinician-collected anal swabs for HPV genotyping.
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Affiliation(s)
- Racheal S. Dube Mandishora
- Department of Medical Microbiology, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France
| | - Trine B. Rounge
- Department of Research, Cancer Registry of Norway, Oslo, Norway
- Department of Informatics, University of Oslo, Oslo, Norway
| | - Megan Fitzpatrick
- Department of Pathology, University of Wisconsin, Madison, Wisconsin, United States of America
| | - Irene Kraus Christiansen
- Department of Microbiology and Infection Control, The Norwegian HPV Reference Laboratory, Akershus University Hospital, Lørenskog, Norway
- Department of Clinical Molecular Biology (EpiGen), Division of Medicine, Akershus University Hospital and University of Oslo, Lørenskog, Norway
| | - Ole Herman Ambur
- Faculty of Health Sciences, OsloMet—Oslo Metropolitan University, Oslo, Norway
| | - Sonja Lagström
- Department of Research, Cancer Registry of Norway, Oslo, Norway
- Department of Microbiology and Infection Control, The Norwegian HPV Reference Laboratory, Akershus University Hospital, Lørenskog, Norway
| | - Babill Stray-Pedersen
- Women’s Clinic, Rikshospitalet, Oslo University Hospital and Institute of Clinical Medicine, Oslo, Norway
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France
| | - Joel Palefsky
- Department of Medicine, UCSF School of Medicine, San Francisco, CA, United States of America
| | - Zvavahera M. Chirenje
- Department of Obstetrics and Gynaecology, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
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Kamath Mulki A, Withers M. Human Papilloma Virus self-sampling performance in low- and middle-income countries. BMC Womens Health 2021; 21:12. [PMID: 33407355 PMCID: PMC7789658 DOI: 10.1186/s12905-020-01158-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/20/2020] [Indexed: 12/24/2022]
Abstract
Background Screening for HPV has led to significant reductions in cervical cancer deaths in high-income countries. However, the same results have not been achieved in low- and middle-income countries (LMICs). HPV self-sampling is a novel approach that could improve screening rates. Methods This study’s objective is to summarize the recent literature on HPV self-sampling in LMICs, focusing on sensitivity/specificity, and feasibility/acceptability of self-sampling compared to traditional screening methods. We conducted a PubMed search for articles published in English within the last 10 years on self-sampling in LMICs.
Results Fifty eligible articles from 26 countries were included, 19 of which came from sub-Saharan Africa and 18 from Latin America/Caribbean. Seven studies examined sensitivity, with five reporting rates higher than 91%. Six reported on specificity, which was also very high at 86–97.8%. Six studies examined self-sampling concordance with provider-collected sampling, with concordance rates ranging from 87 to 97.5%. A total of 38 studies examined the feasibility/acceptability of HPV self-sampling. Participation rates were very high in all studies, even when self-sampling was done at participants’ homes (over 89% participation). Overall, participants reported that HPV self-sampling was easy to perform (75–97%, 18 studies), painless (60–90%, nine studies), and preferred over provider-collected sampling (57–100%, 14 studies). Eight studies reported follow-up rates for participants who completed self-sampling; however, these rates varied widely-from 13.7 to 90%. The major benefits of self-sampling include convenience of screening from home, less embarrassment, and less travel. Improved education and awareness of self-sampling, combined with support from community health workers, could reduce perceptions of self-sampling being inferior to provider-collected sampling. Improving follow-up of abnormal results and improving linkages to treatment are also essential. Conclusion Our literature review highlights HPV self-sampling is a well-performing test that shows promise in terms of expanding screening efforts for the prevention of cervical cancer-related deaths in LMICs.
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Affiliation(s)
- Ashwini Kamath Mulki
- Department of Family Medicine, Lehigh Valley Health Network, 1730 Chew St, Allentown, PA, 18104, USA. .,Keck School of Medicine, University of Southern California, 2001 N Soto Street SSB 318G, Los Angeles, CA, 90032, USA.
| | - Mellissa Withers
- Keck School of Medicine, University of Southern California, 2001 N Soto Street SSB 318G, Los Angeles, CA, 90032, USA
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Linde DS, Andersen MS, Mwaiselage J, Manongi R, Kjaer SK, Rasch V. Effectiveness of One-Way Text Messaging on Attendance to Follow-Up Cervical Cancer Screening Among Human Papillomavirus-Positive Tanzanian Women (Connected2Care): Parallel-Group Randomized Controlled Trial. J Med Internet Res 2020; 22:e15863. [PMID: 32238335 PMCID: PMC7163417 DOI: 10.2196/15863] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 12/16/2019] [Accepted: 12/19/2019] [Indexed: 01/02/2023] Open
Abstract
Background Rapid human papillomavirus (HPV) DNA testing is an emerging cervical cancer screening strategy in resource-limited countries, yet it requires follow-up of women who test HPV positive. Objective This study aimed to determine if one-way text messages improved attendance to a 14-month follow-up cervical cancer screening among HPV-positive women. Methods This multicenter, parallel-group randomized controlled trial was conducted at 3 hospitals in Tanzania. Eligible participants were aged between 25 and 60 years, had tested positive to a rapid HPV test during a patient-initiated screening, had been informed of their HPV result, and had a private mobile phone with a valid number. Participants were randomly assigned in a 1:1 ratio to the intervention or control group through an incorporated algorithm in the text message system. The intervention group received one-way text messages, and the control group received no text messages. The primary outcome was attendance at a 14-month health provider-initiated follow-up screening. Participants were not blinded, but outcome assessors were. The analysis was based on intention to treat. Results Between August 2015 and July 2017, 4080 women were screened for cervical cancer, of which 705 were included in this trial—358 women were allocated to the intervention group, and 347 women were allocated to the control group. Moreover, 16 women were excluded before the analysis because they developed cervical cancer or died (8 from each group). In the intervention group, 24.0% (84/350) women attended their follow-up screening, and in the control group, 23.8% (80/335) women attended their follow-up screening (risk ratio 1.02, 95% CI 0.79-1.33). Conclusions Attendance to a health provider-initiated follow-up cervical cancer screening among HPV-positive women was strikingly low, and one-way text messages did not improve the attendance rate. Implementation of rapid HPV testing as a primary screening method at the clinic level entails the challenge of ensuring a proper follow-up of women. Trial Registration ClinicalTrials.gov NCT02509702; https://clinicaltrials.gov/ct2/show/NCT02509702. International Registered Report Identifier (IRRID) RR2-10.2196/10.2196/15863
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Affiliation(s)
- Ditte S Linde
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Obstetrics and Gynaecology, Odense University Hospital, Odense, Denmark.,Odense Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Marianne S Andersen
- Department of Medical Endocrinology, Odense University Hospital, Odense, Denmark
| | - Julius Mwaiselage
- Department for Cancer Prevention Services, Ocean Road Cancer Institute, Dar es Salaam, United Republic of Tanzania
| | - Rachel Manongi
- Department of Public Health, Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania
| | - Susanne K Kjaer
- Department of Gynaecology, Rigshospitalet University Hospital, Copenhagen, Denmark.,Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Vibeke Rasch
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Obstetrics and Gynaecology, Odense University Hospital, Odense, Denmark
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13
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Nodjikouambaye ZA, Adawaye C, Mboumba Bouassa RS, Sadjoli D, Bélec L. A systematic review of self-sampling for HPV testing in Africa. Int J Gynaecol Obstet 2020; 149:123-129. [PMID: 32037532 DOI: 10.1002/ijgo.13112] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 11/24/2019] [Accepted: 02/06/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Human papillomavirus (HPV) testing may be feasible for primary cervical cancer screening in low-resource countries. OBJECTIVE To compare self-sampling by women with clinician-performed sampling for HPV testing in Africa. SEARCH STRATEGY MEDLINE, Google scholar, EMBASE, and several journals were searched from 2000 until 2015 using relevant terms. SELECTION CRITERIA Selected studies compared self-sampled and clinician-sampled HPV tests. DATA COLLECTION AND ANALYSIS Data extraction forms included description of the type of HPV screening, description of any additional intervention components, study design, sample size, follow-up periods, analytic approach, reported numerical outcomes, results, and limitations. RESULTS Twenty-five studies were identified. Women of a wide age range were successful at self-sampling in many African countries. More than 95% of self-samples yielded HPV DNA results. The concordance in test results between self-collected samples and clinician-collected samples was reasonably high in most studies. In all studies, the quality of cytology from self-sampling matched that of clinician-sampling. Women were generally positive about self-collection, but noted some concerns. CONCLUSION Self-sampling for HPV DNA testing seems to represent a feasible alternative to the Pap test. Further research is needed to provide a solid evidence base to inform using of self-sampling for HPV DNA testing for primary cervical cancer screening.
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Affiliation(s)
- Zita Aleyo Nodjikouambaye
- Ecole Doctorale Régionale d'Infectiologie Tropicale, Franceville, Gabon.,Cabinet Médical de Gynécologie Obstétrique "La Renaissance Plus", N'Djamena, Chad
| | - Chatté Adawaye
- Institut National Supérieur des Sciences et Techniques d'Abéché, Abéché, Chad
| | - Ralph-Sydney Mboumba Bouassa
- Ecole Doctorale Régionale d'Infectiologie Tropicale, Franceville, Gabon.,Laboratoire de Virologie, Hôpital Européen Georges Pompidou, Paris, France.,Faculté de Médecine Paris Descartes, Université Paris Descartes (Paris V), Sorbonne Paris Cité, Paris, France
| | - Damthéou Sadjoli
- Cabinet Médical de Gynécologie Obstétrique "La Renaissance Plus", N'Djamena, Chad.,Service de Gynécologie-Obstétrique, Hôpital de la Mère et de l'Enfant, N'Djamena, Chad.,Faculte' des Sciences de la Sante' Humaine, Universite' de N'Djamena, N'Djamena, Chad
| | - Laurent Bélec
- Laboratoire de Virologie, Hôpital Européen Georges Pompidou, Paris, France.,Faculté de Médecine Paris Descartes, Université Paris Descartes (Paris V), Sorbonne Paris Cité, Paris, France
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14
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Caleia AI, Pires C, Pereira JDF, Pinto-Ribeiro F, Longatto-Filho A. Self-Sampling as a Plausible Alternative to Screen Cervical Cancer Precursor Lesions in a Population with Low Adherence to Screening: A Systematic Review. Acta Cytol 2020; 64:332-343. [PMID: 31958789 DOI: 10.1159/000505121] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 11/28/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Cervical cancer is the fourth most common cancer in the world. A raised incidence and mortality parallel a low participation rate in screening, namely screening in poor countries and among specific populations of developed countries. Cervical or vaginal self-sampling may increase adherence to screening due to its low costs and elevated sensibility and specificity. Our main goal was to compare self-sampling with physician sampling and to evaluate the participation rate of women formerly non-adherent to cervical cancer screening. STUDY DESIGN We identified relevant studies from PubMed. Studies were eligible for inclusion if they fulfilled the following criteria: women aged between 16 and 80 years, poor and developed countries that use self-sampling, women with a low participation rate in screening and studies published since 2013. After fully reading the articles, data were extracted to an Excel sheet to -display all relevant information in an organized manner. -Results: We identified 18 studies, which altogether enrolled 22,118 women. Self-sampling and physician sampling are quite similar regarding the HPV detection rate. Women have a low participation rate mainly because of limited access to health services, religious and culture beliefs, and lack of time due to several demanding tasks in daily life. Self-sampling shows a significant increase in acceptability and preference compared to physician sampling. CONCLUSION Self-sampling is a reliable method to involve women in opportunistic or organized screening programs for cervical cancer prevention.
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Affiliation(s)
- Ana Isabel Caleia
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
| | - Catarina Pires
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
| | - Jacinta de Fátima Pereira
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
| | - Filipa Pinto-Ribeiro
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
| | - Adhemar Longatto-Filho
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal,
- ICVS/3B's-PT Government Associate Laboratory, Guimarães, Portugal,
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil,
- Laboratory of Medical Investigation (LIM-14), School of Medicine, University of Sao Paulo, Sao Paulo, Brazil,
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15
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Mbatha JN, Galappaththi-Arachchige HN, Mtshali A, Taylor M, Ndhlovu PD, Kjetland EF, Baay MFD, Mkhize-Kwitshana ZL. Correction to: Self-sampling for human papillomavirus testing among rural young women of KwaZulu-Natal, South Africa. BMC Res Notes 2018; 11:153. [PMID: 29482602 PMCID: PMC6389066 DOI: 10.1186/s13104-018-3252-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 02/16/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- J N Mbatha
- School Laboratory Medicine and Medical Science, University of KwaZulu-Natal, Durban, South Africa. .,Department of Biomedical and Clinical Technology, Durban University of Technology, PO Box 1334, Durban, 4000, South Africa.
| | - H N Galappaththi-Arachchige
- Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - A Mtshali
- School Laboratory Medicine and Medical Science, University of KwaZulu-Natal, Durban, South Africa
| | - M Taylor
- Discipline of Public Health, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - P D Ndhlovu
- Claybrook Center, Imperial College London, London, UK
| | - E F Kjetland
- Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway.,Discipline of Public Health, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - M F D Baay
- Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway.,Laboratory of Cancer Research and Clinical Oncology, University of Antwerp, Antwerp, Belgium
| | - Z L Mkhize-Kwitshana
- School Laboratory Medicine and Medical Science, University of KwaZulu-Natal, Durban, South Africa.,Department of Biomedical Sciences, Mangosuthu University of Technology, Durban, South Africa
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