HPV self-sampling with mRNA testing benefits routine screening
Menée en Finlande auprès de 5 350 femmes invitées à participer à un programme de dépistage du cancer du col de l'utérus, cette étude analyse la faisabilité et l'effet, sur l'efficacité du dépistage, d'un auto-prélèvement cervico-vaginal avec test recherchant l'ARN messager du papillomavirus humain
Abstract High risk human papillomavirus (hrHPV) based screening provides the possibility of vaginal self-sampling as a tool to increase screening attendance. In order to evaluate the impact and feasibility of opt-in self-sampling in the Finnish setting, we invited a randomized population of 5,350 women not attending screening after age group invitation or after reminder, to attend HPV self-sampling-based screening in the autumn of 2018 in Helsinki. Out of those, 1,282 (24.0%) expressed their interest and ordered the sampling package. Eventually 787 women (14.7% of the total invited population) took part in screening, 770 women by providing a vaginal sample within 2 months from invitation and 17 by providing a pap smear in the laboratory. Self-taken samples were collected in Aptima Multitest vials and tested using the Aptima HPV mRNA Assay. A high proportion, 158/770 (20.5%) of the samples were positive in the Aptima HPV assay. 141 samples were further submitted to Aptima HPV Genotyping and extended genotyping by a Luminex based assay. Of those, 23 samples (16.3%) were HPV 16 positive and 7 (5.0%) were positive for HPV 18/45; extended genotyping revealed multiple high-risk and low-risk HPV genotypes. At follow-up 7 cases of high-grade squamous intraepithelial lesion (HSIL) were diagnosed, which represents 4.4% of HPV positive women and 0.9% of screened women, whereas the rate was 0.5% in routine screening. Our findings suggest that self-sampling with HPV mRNA testing is a feasible approach to improve screening efficacy in a high-risk population among original non-attendees. This article is protected by copyright. All rights reserved.
International Journal of Cancer , résumé, 2022