Περίληψη:
Self-sampling for human papillomavirus (HPV) testing is an alternative to physician sampling particularly for cervical cancer screening nonattenders. The GRECOSELF study is a nationwide observational cross-sectional study aiming to suggest a way to implement HPV-DNA testing in conjunction with self-sampling for cervical cancer screening in Greece, utilizing a midwifery network. Women residing in remote areas of Greece were approached by midwives, of a nationwide network, and were provided with a self-collection kit (dry swab) for cervicovaginal sampling and asked to answer a questionnaire about their cervical cancer screening history. Each sample was tested for high-risk (hr) HPV with the Cobas HPV test. HrHPV-Positive women were referred to undergo colposcopy and, if needed, treatment according to colposcopy/biopsy results. Between May 2016 and November 2018, 13,111 women were recruited. Of these, 12,787 women gave valid answers in the study questionnaire and had valid HPV-DNA results; hrHPV prevalence was 8.3%; high-grade cervical/vaginal disease or cancer prevalence was 0.6%. HrHPV positivity rate decreased with age from 20.7% for women aged 25-29 years to 5.1% for women aged 50-60 years. Positive predictive value for hrHPV testing and for HPV16/18 genotyping ranged from 5.0% to 11.6% and from 11.8% to 27.0%, respectively, in different age groups. Compliance to colposcopy referral rate ranged from 68.6% (for women 25-29) to 76.3% (for women 40-49). For women residing in remote areas of Greece, the detection of hrHPV DNA with the Cobas HPV test, on self-collected cervicovaginal samples using dry cotton swabs, which are provided by visiting midwives, is a promising method for cervical cancer secondary prevention. ©2019 American Association for Cancer Research.
Συγγραφείς:
Agorastos, T.
Chatzistamatiou, K.
Tsertanidou, A.
Mouchtaropoulou, E.
Pasentsis, K.
Kitsou, A.
Moysiadis, T.
Moschaki, V.
Skenderi, A.
Katsiki, E.
Aggelidou, S.
Venizelos, I.
Ntoula, M.
Daponte, A.
Vanakara, P.
Garas, A.
Stefos, T.
Vrekoussis, T.
Lymberis, V.
Kontomanolis, E.N.
Makrigiannakis, A.
Manidakis, G.
Deligeoroglou, E.
Panoskaltsis, T.
Decavalas, G.O.
Michail, G.
Kalogiannidis, I.
Koukoulis, G.
Zempili, P.
Halatsi, D.
Truva, T.
Piha, V.
Agelena, G.
Chronopoulou, A.
Vaitsi, V.
Chatzaki, E.
Paschopoulos, M.
Adonakis, G.
Kaufmann, A.M.
Hadzidimitriou, A.
Stamatopoulos, K.
Λέξεις-κλειδιά:
adult; age distribution; aged; Article; cancer grading; cancer risk; cancer screening; cancer surgery; chemoradiotherapy; cohort analysis; colposcopy; cross-sectional study; DNA screening; female; genotype; Greece; health care planning; high risk population; histopathology; human; Human papillomavirus type 16; Human papillomavirus type 18; human tissue; hysterectomy; major clinical study; middle aged; midwife; nonhuman; observational study; Papanicolaou test; patient compliance; patient referral; predictive value; prevalence; priority journal; questionnaire; risk assessment; rural area; sampling; self sampling; uterine cervix cancer; uterine cervix carcinoma; uterine cervix carcinoma in situ; virus detection; Wart virus; adolescent; community care; complication; early cancer diagnosis; genetics; Human papillomavirus DNA test; isolation and purification; mass screening; nurse attitude; nurse midwife; organization and management; Papillomaviridae; papillomavirus infection; pathology; procedures; rural population; self evaluation; specimen handling; uterine cervix carcinoma in situ; uterine cervix tumor; vagina smear; young adult, virus DNA, Adolescent; Adult; Aged; Cervical Intraepithelial Neoplasia; Colposcopy; Community Networks; Cross-Sectional Studies; Diagnostic Self Evaluation; DNA, Viral; Early Detection of Cancer; Female; Greece; Human Papillomavirus DNA Tests; Humans; Implementation Science; Mass Screening; Middle Aged; Midwifery; Nurse Midwives; Nurse's Role; Papillomaviridae; Papillomavirus Infections; Rural Population; Specimen Handling; Uterine Cervical Neoplasms; Vaginal Smears; Young Adult
