Feasibility Of Community Based Tampon Self-Sampling To Prevent Cervical Cancer

基于社区的卫生棉条自我采样预防宫颈癌的可行性

• 批准号: 8383953
• 负责人: ELIZABETH T. H. FONTHAM
• 金额: $ 21.47万
• 依托单位: LSU HEALTH SCIENCES CENTER
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2014-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8383953
• 关键词: 21 year old; Appointment; Cervical; Cervical Cancer Screening; Client; Clinic; Clinic Visits; Clinical; Collection; Communities; Community Health; Community Outreach; DNA; Disadvantaged; Gynecologist; Gynecology; Health; Home environment; Human Papillomavirus; Human papillomavirus 16; Incidence; Infection; Instruction; Life; Link; Mails; Malignant neoplasm of cervix uteri; Medically Underserved Area; Methods; Pap smear; Participant; Patients; Pelvic Examination; Physicians' Offices; Population; Positive Test Result; Process; Questionnaires; Randomized; Recruitment Activity; Research; Resources; Risk; Sampling; Screening procedure; Self-Administered; Services; Solutions; Surveys; Swab; Tampons; Techniques; Testing; Time; Urine; Vagina; Vaginal Tampons; Virus; Visit; Woman; Women' s Group; arm; base; cervical cancer prevention; community setting; compare effectiveness; follow-up; high risk; low socioeconomic status; medically underserved; mortality; novel strategies; older women; prevent; satisfaction; standard of care

DESCRIPTION (provided by applicant): Medically underserved women are generally at higher risk for many health problems including cervical cancer. Solutions can often be found by utilizing resources within the community. An academic-community partnership has been formed to develop a novel approach to screening for cervical cancer. High risk types of human papillomavirus (HPV), 16, 18 and others, are etiologically linked to cervical cancer. HPV can be detected from samples obtained from self-swabbing of the vagina, urine testing, or insertion of tampons. These methods could be performed in the community or at home by women, which is useful for the group of women not visiting the gynecologist to receive recommended testing. This study will compare the effectiveness of home-based self sampling screening for cervical cancer with conventional Pap testing in a community-based setting. Given the ease of home use, it is hypothesized that home-based tampon testing for HPV DNA will be equal or superior to the annual Pap testing. For such home sampling to be effective, it must be: (1) used at least as much as current referral rates to the gynecologist; (2) acceptable to the woman as a means to prevent cervical cancer; (3) able to be performed at home; and (4) able to identify those women at risk for developing cervical cancer. The specific aims of this project are to: compare compliance with a home-sampling tampon HPV test to compliance with clinic Pap testing; assess a high risk population's acceptance of home use of a tampon for HPV testing in general and compared to traditional clinically administered Pap testing; assess a high risk population's ability to correctly follow instructions for home tampon sampling for HPV testing; and assess the accuracy of the home administered tampon HPV results. In order to achieve these aims, a group of women will be asked to administer the tampon sampling at home and return via mail. Another group will have conventional Pap testing for comparison. Surveys of satisfaction will also be conducted. PUBLIC HEALTH RELEVANCE: Because cervical cancer can be prevented through regular Papanicolaou (Pap) testing and follow-up with treatment of abnormal findings, the rates of cervical cancer have been dramatically reduced in the past decades; yet many women, particularly older women who no longer use gynecological services, do not receive the recommended testing which results in what would have been preventable cases of cervical cancer. Infection with human papillomavirus (HPV) is linked to cervical cancer and testing of HPV itself in a community setting offers another mechanism for preventing cervical cancer. Self-administered, home-based sampling for HPV testing is an opportunity to reach those women who are not visiting the gynecologist for cervical cancer screening.

描述（由申请人提供）：在医学上服务不足的妇女通常会面临包括宫颈癌在内的许多健康问题的较高风险。通常可以通过在社区内利用资源来找到解决方案。已经形成了一种学术社区伙伴关系，以开发一种新型的宫颈癌筛查方法。 人类乳头瘤病毒（HPV），16、18等的高风险类型在病因上与宫颈癌有关。可以从阴道自我切割，尿液测试或塞卫生棉条插入的样品中检测到HPV。这些方法可以在社区中或由妇女在家中进行，这对于未访问妇科医生接受推荐测试的女性很有用。这项研究将在基于社区的环境中比较宫颈癌的自我抽样筛查与常规的子宫颈抹片测试的有效性。鉴于易于家庭使用，可以假设对HPV DNA的家庭卫生棉条测试将相等或优于年度PAP测试。为了使此类家庭采样有效，必须是：（1）至少使用当前转诊率与妇科医生一样多； （2）该妇女可以接受作为预防宫颈癌的一种手段； （3）能够在家中表演； （4）能够确定那些有宫颈癌风险的女性。 该项目的具体目的是：将符合家庭采样的棉塞HPV测试与遵守诊所的子宫颈抹片测试进行比较；一般而言，评估高风险人群接受卫生棉条进行HPV测试的家庭使用，并与传统的临床管理子宫颈抹片检查相比；评估高风险人群正确遵循HPV测试的家庭卫生棉条抽样的说明的能力；并评估家庭管理的卫生棉条HPV结果的准确性。为了实现这些目标，将要求一群妇女在家管理卫生棉条抽样并通过邮件返回。另一组将进行常规的子宫颈抹片测试以进行比较。还将进行满意调查。 公共卫生相关性：由于可以通过常规的Papanicolaou（PAP）测试和对异常发现的治疗进行随访，因此可以预防宫颈癌，因此在过去几十年中，宫颈癌的发生率已大大降低。然而，许多妇女，尤其是不再使用妇科服务的老年妇女，没有接受建议的测试，这导致可以预防的宫颈癌病例。人乳头瘤病毒（HPV）感染与宫颈癌有关，在社区环境中对HPV的测试则提供了预防宫颈癌的另一种机制。自我管理，以家庭为基础的HPV测试抽样是一个机会，可以接触那些不访问妇科医生进行宫颈癌筛查的妇女。