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Showing content from https://pubmed.ncbi.nlm.nih.gov/23618210/ below:

Self-collected HPV testing improves participation in cervical cancer screening: a systematic review and meta-analysis

Review

Affiliations

• ¹ Dalla Lana School of Public Health, University of Toronto, Toronto, ON. sarai.racey@gmail.com

• PMID: 23618210
• PMCID: PMC6973997
• DOI: 10.1007/BF03405681

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Review

C Sarai Racey et al. Can J Public Health. 2013.

• ¹ Dalla Lana School of Public Health, University of Toronto, Toronto, ON. sarai.racey@gmail.com

• PMID: 23618210
• PMCID: PMC6973997
• DOI: 10.1007/BF03405681

Item in Clipboard

Objective: HPV testing has emerged as an effective cervical cancer screening test. The use of HPV self-testing has the potential to address many barriers to screening and reach at-risk women through engagement in screening. However, there is a need to examine the evidence for whether offering self-collected HPV testing in practice increases screening compliance. The objective of this review is to determine to what extent providing self-collected HPV testing increases screening participation in women who are never or underscreened for cervical cancer.

Methods: A systematic literature review conducted in the databases Medline and Embase identified articles examining the use of HPV self-testing on cervical cancer screening participation. A meta-analysis using a random-effects model was used to calculate the relative compliance, with an intent-to-treat analysis of HPV self-testing compared to Pap testing, with 95% confidence intervals (CI). All statistical tests were two-sided.

Synthesis: Ten studies were reviewed, with 8 being European and 2 North American. Of the 10 studies, 9 employed a randomized design. In all studies, the relative compliance of HPV self-collected testing compared to Pap testing was significantly greater than 1.0 (p<0.01). The overall relative compliance was 2.14 (95% CI 1.30-3.52). There was large heterogeneity of screening compliance between studies for both HPV self-testing and Pap testing.

Conclusion: HPV self-collected testing significantly improved the participation of women who did not routinely attend cervical cancer screening programs. New approaches to HPV self-test delivery should be considered as HPV testing becomes more widely incorporated as a primary screening tool.

Objectif: Le test du VPH se montre efficace pour dépister le cancer du col utérin. Le recours à l’autotest du VPH pourrait potentiellement surmonter un bon nombre des obstacles au dépistage et joindre les femmes à risque en les faisant participer au dépistage. Il faut cependant examiner les preuves pour voir si le fait d’offrir l’autotest du VPH augmente en pratique le recours au dépistage. Nous avons cherché à déterminer dans quelle mesure le fait d’offrir l’autotest du VPH augmente le recours au dépistage chez les femmes qui ne sont jamais ou qui sont insuffisamment examinées pour le cancer du col utérin.

MÉTHODE: Une revue systématique de la littérature spécialisée dans les bases de données Medline et Embase a permis de recenser les articles traitant de l’utilisation de l’autotest du VPH pour dépister le cancer du col utérin. Nous avons effectué une méta-analyse à l’aide d’un modèle à effets aléatoires pour calculer la conformité relative, avec une analyse en intention de traiter de l’autotest du VPH comparativement au dépistage par frottis de Papanicolaou, avec des intervalles de confiance (IC) de 95 %. Tous les tests statistiques étaient bilatéraux.

Synthèse: Dix études ont été examinées dont huit européennes et deux nord-américaines. Sur les 10 études, neuf employaient un plan d’étude aléatoire. Dans toutes les études, la conformité relative de l’autotest du VPH par rapport au frottis était significativement plus élevée que 1,0 (p<0,01). La conformité relative globale était de 2,14 (IC de 95 %: 1,30–3,52). La conformité au dépistage était très hétérogène d’une étude à l’autre, tant pour l’autotest du VPH que pour le dépistage par frottis.

CONCLUSION: L’autotest du VPH améliorait significativement la participation des femmes qui n’avaient pas systématiquement recours aux programmes de dépistage du cancer du col utérin. De nouvelles approches de prestation de l’autotest du VPH devraient être envisagées à mesure que l’intégration du test du VPH en tant qu’outil de dépistage primaire se généralise.

Keywords: Human papillomavirus; cervical cancer screening; review; self collected specimens; under-screening.

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