临床研究
ENGLISH ABSTRACT
宫颈癌筛查不同取样方法的人群接受度评价
徐慧芳
余艳琴
党乐
赵雪莲
韦梦娜
胡尚英
赵方辉
乔友林
作者及单位信息
·
DOI: 10.3760/cma.j.cn112152-20190419-00252
Acceptance evaluation of urine self-sampling, vaginal self-sampling and physician sampling in cervical cancer screening
Xu Huifang
Yu Yanqin
Dang Le
Zhao Xuelian
Wei Mengna
Hu Shangying
Zhao Fanghui
Qiao Youlin
Authors Info & Affiliations
Xu Huifang
Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Yu Yanqin
Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Dang Le
Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Zhao Xuelian
Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Wei Mengna
Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Hu Shangying
Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Zhao Fanghui
Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Qiao Youlin
Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
·
DOI: 10.3760/cma.j.cn112152-20190419-00252
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摘要

目的探讨尿液、阴道自我取样和妇科医师取样用于宫颈癌筛查的的人群接受度。

方法对2015年和2018年于山西省襄垣县和阳城县参加宫颈癌筛查者进行问卷调查,问卷内容共3部分,分别为受检者在尿液、阴道自我取样和妇科医师取样过程中的主观感受,对不同取样方法的接受度及对自我取样方法的难易程度评价。

结果共收回有效问卷3 485份。在尿液、阴道自我取样和妇科医师取样过程中,分别有2.3%(81/3 472)、7.1%(247/3 472)和8.6%(299/3 472)的受检者感觉尴尬或难为情,1.3%(46/3 472)、9.7%(337/3 472)和14.9%(518/3 472)的受检者感觉不适,1.0%(35/3 469)、8.5%(295/3 469)和15.3%(531/3 469)的受检者感觉疼痛,98.3%(3 334/3 393)、96.3%(3 267/3 393)和99.0%(3 360/3 393)的受检者认为取样操作规范正确(均 P<0.05)。根据取样过程中的感受,66.5%(2 037/3 064)愿意采用妇科医师取样,其次为尿液自我取样(61.2%,1 876/3 064)及阴道自我取样(39.1%,1 199/3 064,均 P<0.05)。若筛查结果准确性相同,在宫颈癌筛查中,愿意采用自我取样、医师取样方法者占比分别为31.8%(1 109/3 485)和68.2%(2 376/3 485);愿意采用尿液自我取样、阴道自我取样者分别为76.5%(2 662/3 482)和23.5%(820/3 482)。86.5%(3 007/3 478)的受检者认为尿液自我取样非常容易,而仅40.9%(1 423/3 478)认为阴道自我取样非常容易。

结论在尿液自我取样过程中,受检者产生不适感的程度及比例低于妇科医师取样和阴道自我取样。妇科医师取样的人群接受度最高,尿液自我取样次之,阴道自我取样接受度最低。尿液自我取样比阴道自我取样容易。

宫颈肿瘤;自我取样;医师取样;尿液;接受度
ABSTRACT

ObjectiveTo compare the acceptance of urine self-sampling, vaginal self-sampling and physician sampling in cervical cancer screening.

MethodsQuestionnaire surveys were conducted in women attending cervical cancer screening in Xiangyuan County and Yangcheng County in Shanxi Province from July to November 2015 and from October to December 2018. Both surveys included the following three parts: feelings and acceptance of women in urine self-sampling, vaginal self-sampling and physician sampling, and the ease evaluation of two self-samplings.

ResultsThere were 3 485 questionnaires were collected finally. The proportions of women felt embarrassed in urine self-sampling, vaginal self-sampling and physician sampling were 2.3% (81/3 472), 7.1% (247/3 472) and 8.6% (299/3 472), and 1.3% (46/3 472), 9.7%(3 37/3 472) and 14.9% (518/3 472) of women felt uncomfortable, and 1.0% (35/3 469), 8.5% (295/3 469) and 15.3% (531/3 469) felt pain, and 98.3% (3 334/3 393), 96.3% (3 267/3 393) and 99.0% (3 360/3 393) thought that the sampling were conducted properly ( P<0.05). Based on the feeling during sample collection, 61.2% (1 876/3 064), 39.1% (1 199/3 064) and 66.5% (2 037/3 064) women were willing to use the corresponded sampling methods in cervical cancer screening, respectively ( P<0.05). If the accuracy was the same, there were 31.8% (1 109/3 485) women preferred self-sampling and 68.2% (2 376/3 485) preferred physician sampling for cervical cancer screening. Meanwhile, 23.5% (820/3 482) preferred vaginal self-sampling in comparison with 76.5% (2 662/3 482) for urine self-sampling in cervical cancer screening. 86.5% (3 007/3 478) of the women thought urine self-sampling was very easy, comparing 40.9% (1 423/3 478) for vaginal self-sampling.

ConclusionsThe bad feeling of women during urine self-sampling is less common and less serious than those during physician sampling and vaginal self-sampling, and the acceptance for physician sampling is highest, following by urine self-sampling and vaginal self-sampling. Urine self-sampling is much easier than vaginal self-sampling.

Cervical cancer;Self-sampling;Physician sampling;Urine;Acceptance
Qiao Youlin, Email: nc.defcaab.smacicyoaiq
引用本文

徐慧芳,余艳琴,党乐,等. 宫颈癌筛查不同取样方法的人群接受度评价[J]. 中华肿瘤杂志,2021,43(12):1282-1286.

DOI:10.3760/cma.j.cn112152-20190419-00252

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评价本文
*以上评分为匿名评价
宫颈癌是影响女性健康的第4大恶性肿瘤,2018年全球有57万女性被诊断为宫颈癌,31.1万死于宫颈癌,高达86%的女性来自于欠发达国家和地区 [ 1 ]。目前,人乳头状瘤病毒(human papillomavirus, HPV)检测和液基细胞学检查(liquid-based cytology, LBC)是宫颈癌筛查的重要手段 [ 2 , 3 ],但是,HPV和LBC主要采用宫颈脱落细胞学标本,取样依赖妇科医师。在欠发达国家和地区,医疗资源相对匮乏,依靠妇科医师取样进行宫颈癌筛查难度较大,可能影响宫颈癌筛查的可行性以及人群覆盖率 [ 4 ]。目前,阴道自我取样已经在研究中证实可以用于HPV检测 [ 5 ],且其筛查效果与现有筛查策略具有可比性。虽然阴道自我取样在一定程度上弥补了妇科医师取样的局限性,但取样过程依然具有侵入性,在取样过程中,受检者可能会出现疼痛、出血等情况,部分受检者也会因为害羞、恐惧、风俗习惯等原因拒绝参加宫颈癌筛查 [ 6 , 7 , 8 ]。而且,未充分参加筛查者发生高级别宫颈癌前病变的可能性高于充分筛查者 [ 9 , 10 , 11 ]。近年来,预防性HPV疫苗在国内外全面上市,如何有效开展疫苗上市后人群保护效果监测也是研究的热点之一。尿液自我取样过程简单、方便、无创,取样过程不影响机体的感染状态 [ 8 , 12 ]。有研究显示,尿液自我取样在宫颈癌筛查中有良好的应用前景 [ 13 , 14 , 15 , 16 ]。然而,探讨尿液自我取样在人群中的接受度的研究鲜见。本研究中,我们通过对比宫颈癌筛查中尿液自我取样、阴道自我取样和宫颈医师取样的人群接受度,为探索适用于宫颈癌筛查的新取样方法提供证据。
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备注信息
A
乔友林,Email: nc.defcaab.smacicyoaiq
B
所有作者均声明不存在利益冲突
C
国家公益性行业科研专项 (201502004)
中国医学科学院医学与健康科技创新工程 (2016-I2M-1-01、2017-I2M-B&R-03)
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