Human Papillomavirus Self-Sampling for Primary Cervical Cancer Screening in Under-Screened Women in Hong Kong during the COVID-19 Pandemic

Ngu, Siew Fei; Lau, Lesley S. K.; Li, Justin; Wong, Grace; Cheung, Annie N. Y.; Ngan, Hextan Y. S.; Chan, Karen Kar Loen

doi:10.3390/ijerph19052610

Cited by 10 publications

(12 citation statements)

References 18 publications

(23 reference statements)

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“… 10 , 11 , 23 - 27 , 29 - 37 , 39 - 47 , 49 , 50 , 54 , 57 - 60 , 63 - 65 , 68 - 71 , 74 Studies reported high satisfaction of self-collection among women, 10 , 11 , 30 , 36 , 42 , 43 , 50 , 58 , 62 , 63 , 65 , 68 , 70 that women were willing to perform self-collection again, 10 , 11 , 23 , 27 , 29 - 31 , 35 , 41 , 49 , 57 , 58 , 60 , 68 , 69 and to recommend self-collection to others. 10 , 11 , 27 , 29 , 30 , 32 , 49 , 50 , 68 Self-collection was commonly described as easy, 10 , 11 , 26 , 29 , 30 , 33 - 36 , 39 - 41 , 43 , 50 ...…”

Section: Resultsmentioning

confidence: 99%

Self-Collection Cervical Screening in the Asia-Pacific Region: A Scoping Review of Implementation Evidence

Creagh

Boyd

Bavor

et al. 2023

JCO Global Oncology

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PURPOSE Although cervical cancer is a disease of inequity, it can be eliminated as a public health problem through vaccination, screening, and treatment. Human papillomavirus vaginal self-collection cervical screening is a high-performance test that can increase reach of screening. This review describes the different contexts and models of care used to pilot or implement self-collection within the Asia-Pacific, measures the extent that implementation outcome measures are reported and, where available, summarizes key implementation findings. METHODS A scoping review was conducted by searching five databases of the peer-reviewed literature on June 20, 2022. Two researchers assessed eligibility and extracted data independently to the model of care used and the Conceptual Framework for Implementation Outcomes. A mixed-method consolidation of findings (quantitative: count and frequencies; qualitative: content analysis) was undertaken to narratively report findings. RESULTS Fifty-seven articles, comprising 50 unique studies from 11 countries and two special autonomous regions, were included; 82% were conducted in trials. The implementation of self-collection was conducted in low- (2%), lower-middle– (32%), upper-middle– (32%), and high-income (35%) settings, with 10 different delivery models used; 80% delivered through practitioner-supported models with diversity in how samples were processed, and treatment was offered. Acceptability (73%) and appropriateness (64%) measures were most reported, followed by adoption (57%), feasibility (48%), and fidelity (38%). Only 7% of articles reported implementation cost or penetration measures. No articles reported sustainability measures. CONCLUSION The literature confirms that self-collection cervical screening has been implemented within the Asia-Pacific region, with evidence demonstrating that it is acceptable and appropriate from the user's perspective. Well-designed, high-quality implementation trials and real-world evaluations of self-collection that report the breadth of implementation outcomes can support the progression toward the elimination of cervical cancer.

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Section: Resultsmentioning

confidence: 99%

Self-Collection Cervical Screening in the Asia-Pacific Region: A Scoping Review of Implementation Evidence

Creagh

Boyd

Bavor

et al. 2023

JCO Global Oncology

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“…Ngu et al likewise reported that the concordance for HPV detection between self-sampled and clinician-sampled specimens was 90.2% (95% con dence interval [CI]: 85.1-93.8%; Cohen's kappa 0.59 [95% CI: 0.42-0.75]) in Hong Kong. These researchers conclude that HPV self-sampling is an effective method for cervical cancer screening and can be considered an effective screening option, especially in women who are reluctant or unable to attend regular screenings [11].…”

Section: Discussionmentioning

confidence: 96%

Mailing human papillomavirus self-sampling kits to women under-screened for cervical cancer improved participation in cervical cancer screening in a general population study in Japan

Nishimura

Matsuura

Terada

et al. 2022

Preprint

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Background One cause of the increase in cervical cancer rates in Japan is the long-term stagnation in the cervical cancer screening consultation rate. Improving the screening consultation rate is therefore of urgent concern to reduce cervical cancer incidence. Self-collected human papilloma virus (HPV) tests have been successfully adopted in several countries, such as Netherlands and Australia, as a measure of individuals who have not undergone cervical cancer screening in national programs. This study aimed to verify whether self-collected HPV tests presented an effective countermeasure for individuals who had not undergone the recommended cervical cancer screenings. Methods This study was conducted from December 2020 to September 2022 in Muroran City, Japan. The primary evaluated endpoints included the percentage of citizens with positive self-collected HPV test results and individuals who underwent cervical cancer screening at a hospital. The secondary endpoints were the percentage of included participants who had undergone any cervical cancer screening and the diagnostic rates. Results The included study participants were 7,653 individuals aged 20–50 years with no record of having undergone a cervical cancer examination in the past 5 years. We mailed these participants information on self-administered HPV tests as an alternative screening procedure and sent the kit to 1,674 women who requested the test, among whom 953 returned the kit. Among the 89 HPV-positive individuals (positive rate, 9.3%), 71 (79.8%) visited the designated hospital for an examination. A closer examination revealed that 13 women (18.3% of hospital visits) had a cervical intraepithelial neoplasia (CIN) finding of CIN2 or higher, among whom one each had cervical cancer and vulvar cancer, eight presented with CIN3, and three presented with CIN2; two cases of invasive gynecologic cancer were also identified. Conclusions We conclude that the self-collected HPV tests showed a certain efficacy as a measure of individuals who had not undergone the recommended cervical cancer screening. We devised ways to have the unexamined patients undergo HPV testing and ensure that HPV-positive individuals visited the hospital. Despite a few limitations, our findings suggest the effectiveness of this public health intervention.

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“…We have seen some examples of acceleration of HPV self-sampling programming in diverse settings, largely thanks to the disruption of routine services caused by COVID-19. Innovative strategies that had been successful in demonstration projects include community-based screening and mail-in HPV self-collection to maintain accessibility of cervical cancer screening services ( Woo et al, 2022 ; Castle et al, 2011 ; Ejegod et al, 2022 ; Winer et al, 2019 ; Ngu et al, 2022 ).…”

Section: Recommendations For Future Actionmentioning

confidence: 99%

COVID-19 as a catalyst for reimagining cervical cancer prevention

Luckett

Feldman

Woo

et al. 2023

eLife

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Cervical cancer has killed millions of women over the past decade. In 2019 the World Health Organization launched the Cervical Cancer Elimination Strategy, which included ambitious targets for vaccination, screening, and treatment. The COVID-19 pandemic disrupted progress on the strategy, but lessons learned during the pandemic - especially in vaccination, self-administered testing, and coordinated mobilization on a global scale - may help with efforts to achieve its targets. However, we must also learn from the failure of the COVID-19 response to include adequate representation of global voices. Efforts to eliminate cervical cancer will only succeed if those countries most affected are involved from the very start of planning. In this article we summarize innovations and highlight missed opportunities in the COVID response, and make recommendations to leverage the COVID experience to accelerate the elimination of cervical cancer globally.

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Human Papillomavirus Self-Sampling for Primary Cervical Cancer Screening in Under-Screened Women in Hong Kong during the COVID-19 Pandemic

Cited by 10 publications

References 18 publications

Self-Collection Cervical Screening in the Asia-Pacific Region: A Scoping Review of Implementation Evidence

Self-Collection Cervical Screening in the Asia-Pacific Region: A Scoping Review of Implementation Evidence

Mailing human papillomavirus self-sampling kits to women under-screened for cervical cancer improved participation in cervical cancer screening in a general population study in Japan

COVID-19 as a catalyst for reimagining cervical cancer prevention

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