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全球范围内使用 HPV 自我采样进行宫颈癌筛查。

Worldwide use of HPV self-sampling for cervical cancer screening.

机构信息

Cancer Epidemiology Research Program, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP CB06/02/0073), Madrid, Spain.

Cancer Epidemiology Research Program, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP CB06/02/0073), Madrid, Spain.

出版信息

Prev Med. 2022 Jan;154:106900. doi: 10.1016/j.ypmed.2021.106900. Epub 2021 Nov 30.

Abstract

An increasing body of evidence supports the validity of self-sampling as an alternative to clinician collection for primary Human Papillomavirus (HPV) screening. Self-sampling effectively reaches underscreened women and can be a powerful strategy in low- and high-resource settings for all target ages. This work aims to summarize the current use of HPV self-sampling worldwide. It is part of a larger project that describes cervical cancer screening programmes and produces standardized coverage estimates worldwide. A systematic review of the literature and official documents supplemented with a formal World Health Organisation country consultation was conducted. Findings show that the global use of HPV self-sampling is still limited. Only 17 (12%) of countries with identified screening programs recommend its use, nine as the primary collection method, and eight to reach underscreened populations. We identified 10 pilots evaluating the switch to self-sampling in well-established screening programs. The global use of self-sampling is likely to increase in the coming years. COVID-19's pandemic has prompted efforts to accelerate HPV self-sampling introduction globally, and it is now considered a key element in scaling up screening coverage. The information generated by the early experiences can be beneficial for decision-making in both new and existing programs.

摘要

越来越多的证据支持自我采样作为临床医生采集的替代方法,用于原发性人乳头瘤病毒(HPV)筛查是有效的。自我采样有效地覆盖了未接受筛查的女性,并且可以成为所有目标年龄段在低资源和高资源环境中的有力策略。这项工作旨在总结全球范围内 HPV 自我采样的当前使用情况。这是描述宫颈癌筛查计划并在全球范围内产生标准化覆盖估计的更大项目的一部分。对文献和官方文件进行了系统审查,并辅以世界卫生组织的正式国家磋商。研究结果表明,HPV 自我采样的全球使用仍然有限。只有 17 个(12%)确定有筛查计划的国家建议使用 HPV 自我采样,其中 9 个国家将其作为主要采集方法,8 个国家用于覆盖未接受筛查的人群。我们发现了 10 项评估在成熟的筛查计划中转向自我采样的试点。未来几年,自我采样的全球使用可能会增加。COVID-19 的大流行促使全球加快 HPV 自我采样的引入,现在它被认为是扩大筛查覆盖范围的关键要素。早期经验所产生的信息对新的和现有的计划的决策都有好处。

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