OBJECTIVE: To evaluate the use of community health agents (CHAs) to instruct women living in poor rural areas in obtaining self-collected cervical samples and compare the high-risk HPV (hrHPV) hybrid capture (HC) results obtained to those for gynecologist-collected samples. METHODS: After a one-day training, CHAs visited sexually active women, instructing each in the use of collection brush and the Universal Collection Medium tube. One week thereafter, a gynecologist collected cervical samples from, and performed colposcopies on, the same women. A single reference lab performed all HCs. RESULTS: 878 women (Age: 15-69 years) participated. Among self-collected samples, hrHPV prevalence was 33.9% (95% CI: 30.8%-37%), compared with 28.6% (95% CI: 27%-30%) among gynecologist-collected samples. However, 9.3% of the patients were HPV HC II-positive in the self-collected sample and HPV HC II-negative in the gynecologist-collected samples (95% CI: 7.38%-11.22%), whereas 4% tested positive in gynecologist-collected samples and negative in self-collected samples (95% CI: 2.7%-5.3%) (P<0.01; kappa=0.7). Of 9 cases of histologically-confirmed, high-grade squamous intraepithelial lesion, self-collected and provider-collected samples missed one each. CONCLUSION: Self-collected vaginal sampling could be made an additional CHA function under existing program conditions, improving access to cervical cancer screening in poor rural settings.
OBJECTIVE: To evaluate the use of community health agents (CHAs) to instruct women living in poor rural areas in obtaining self-collected cervical samples and compare the high-risk HPV (hrHPV) hybrid capture (HC) results obtained to those for gynecologist-collected samples. METHODS: After a one-day training, CHAs visited sexually active women, instructing each in the use of collection brush and the Universal Collection Medium tube. One week thereafter, a gynecologist collected cervical samples from, and performed colposcopies on, the same women. A single reference lab performed all HCs. RESULTS: 878 women (Age: 15-69 years) participated. Among self-collected samples, hrHPV prevalence was 33.9% (95% CI: 30.8%-37%), compared with 28.6% (95% CI: 27%-30%) among gynecologist-collected samples. However, 9.3% of the patients were HPV HC II-positive in the self-collected sample and HPV HC II-negative in the gynecologist-collected samples (95% CI: 7.38%-11.22%), whereas 4% tested positive in gynecologist-collected samples and negative in self-collected samples (95% CI: 2.7%-5.3%) (P<0.01; kappa=0.7). Of 9 cases of histologically-confirmed, high-grade squamous intraepithelial lesion, self-collected and provider-collected samples missed one each. CONCLUSION: Self-collected vaginal sampling could be made an additional CHA function under existing program conditions, improving access to cervical cancer screening in poor rural settings.
Authors: Joel C Boggan; David K Walmer; Gregory Henderson; Nahida Chakhtoura; Schatzi H McCarthy; Harry J Beauvais; Jennifer S Smith Journal: Sex Transm Dis Date: 2015-11 Impact factor: 2.830
Authors: Schatzi H McCarthy; Kathy A Walmer; Joel C Boggan; Margaret W Gichane; William A Calo; Harry A Beauvais; Noel T Brewer Journal: J Low Genit Tract Dis Date: 2017-01 Impact factor: 1.925
Authors: Viola M J Verhoef; Maaike G Dijkstra; Remko P Bosgraaf; Albertus T Hesselink; Willem J G Melchers; Ruud L M Bekkers; Johannes Berkhof; Folkert J van Kemenade Journal: BMC Womens Health Date: 2013-05-02 Impact factor: 2.809
Authors: Anna Gillio-Tos; Maria da Graça Bicalho; Valentina Fiano; Chiara Grasso; Valentina Tarallo; Laura De Marco; Morena Trevisan; Marinabarbaradesousa Xavier; Renata Slowik; Newton S Carvalho; Carlos A Maestri; Hadriano M Lacerda; Daniela Zugna; Lorenzo Richiardi; Franco Merletti Journal: BMC Cancer Date: 2012-12-24 Impact factor: 4.430