1
|
Giubbi C, Martinelli M, Di Meo ML, Njoku RC, Perdoni F, Fruscio R, Landoni F, Cocuzza CE. Evaluation of two alternative non-alcohol-based media for the suspension of self-collected vaginal swabs for HPV testing in cervical cancer screening. Heliyon 2024; 10:e31032. [PMID: 38813186 PMCID: PMC11133750 DOI: 10.1016/j.heliyon.2024.e31032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 05/09/2024] [Accepted: 05/09/2024] [Indexed: 05/31/2024] Open
Abstract
The introduction of Human Papillomavirus (HPV) testing in cervical cancer screening enhanced the opportunity to introduce self-collection as an innovative approach to improve coverage rates. Validation and standardization of the pre-analytical and analytical procedures are crucial for the quality assurance of HPV tests on self-collected samples. This study evaluated the analytical performance and the stability of self-collected vaginal samples resuspended in 5 mL of two non-alcohol-based media, eNat® and MSwab® compared to a professionally collected cervical sample, resuspended in 20 mL ThinPrep®, for the detection of high-risk HPV (hrHPV). The impact of the suspension volumes on analytical performance was also evaluated (2 and 5 ml). A good analytical concordance in hrHPV detection in cervical and vaginal self-collected swabs suspended in 5 ml of both non-alcohol-based media was demonstrated (eNat®: 91.2 %, k = 0.821; MSwab®: 91.4 %; k = 0.798). A similar analytical performance was found for samples resuspended in 2 mL (eNat®: 92.9 %, k = 0.811; MSwab®: 92.9 %, k = 0.811) compared to cervical samples. Good nucleic acid stability was demonstrated for vaginal samples stored at 20-25 °C and 37 °C for up to 4 weeks. Results of this preliminary study support the introduction of these media for vaginal self-sampling-based prevention programs. Nevertheless, further research is necessary to evaluate clinical accuracy in larger settings.
Collapse
Affiliation(s)
- Chiara Giubbi
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | | | | | - Ruth Chinyere Njoku
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- University of Sassari, Department of Biomedical Science, Sassari, Italy
| | - Federica Perdoni
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Robert Fruscio
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Fondazione IRCSS San Gerardo dei Tintori, Monza, Italy
| | - Fabio Landoni
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Fondazione IRCSS San Gerardo dei Tintori, Monza, Italy
| | | |
Collapse
|
2
|
Le Goff J, Le Duc-Banaszuk AS, Lefeuvre C, Pivert A, Ducancelle A, De Pauw H, Arbyn M, Vinay A, Rexand-Galais F. Acceptance of Self-Sampling by Women Not Regularly Participating in Cervical Cancer Screening in Areas with Low Medical Density: A Qualitative Study within the French CapU4 Trial. Cancers (Basel) 2024; 16:2066. [PMID: 38893189 PMCID: PMC11171172 DOI: 10.3390/cancers16112066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 05/27/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
Cervical cancer (CC) was diagnosed in 3159 women in France in 2023, and 1117 died from it. Organized screening for cervical cancer is potentially very effective for participating women. However, reaching under-screened populations remains a major challenge. The present qualitative study explored women's opinions on what discourages or encourages them to participate in CC screening and assessed the acceptability of two experimental strategies (urinary or vaginal self-sampling kits) to increase the screening coverage in three rural French administrative departments with low medical density and/or low screening participation rates. Forty-eight semi-structured interviews and four focus groups were conducted by a team of psychologists. Results showed that the participants accepted at-home self-sampling to reach non-participating women in medically underserved areas. However, they suggested that the type of kit sent should be adapted to the patient's profile (embarrassment from earlier exams, cultural aspects, fear of invasiveness, etc.), and that kits should be simple to use (in understandable language taking sociocultural aspects into account). Women wished to be assured that testing on self-samples is accurate and needed information about further actions in case of a positive result.
Collapse
Affiliation(s)
- Johane Le Goff
- University of Angers, CLiPsy, SFR CONFLUENCES, F-49000 Angers, France; (A.V.); (F.R.-G.)
| | - Anne-Sophie Le Duc-Banaszuk
- Pays de la Loire Regional Cancer Screening Coordination Center (CRCDC Pays de La Loire), F-49000 Angers, France;
| | - Caroline Lefeuvre
- University of Angers, CHU Angers, HIFIH, SFR ICAT, F-49000 Angers, France; (C.L.); (A.P.); (A.D.)
| | - Adeline Pivert
- University of Angers, CHU Angers, HIFIH, SFR ICAT, F-49000 Angers, France; (C.L.); (A.P.); (A.D.)
| | - Alexandra Ducancelle
- University of Angers, CHU Angers, HIFIH, SFR ICAT, F-49000 Angers, France; (C.L.); (A.P.); (A.D.)
| | - Hélène De Pauw
- Unit Cancer Epidemiology, Belgian Cancer Center, Sciensano, B1050 Brussels, Belgium; (H.D.P.); (M.A.)
| | - Marc Arbyn
- Unit Cancer Epidemiology, Belgian Cancer Center, Sciensano, B1050 Brussels, Belgium; (H.D.P.); (M.A.)
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, B9000 Ghent, Belgium
| | - Aubeline Vinay
- University of Angers, CLiPsy, SFR CONFLUENCES, F-49000 Angers, France; (A.V.); (F.R.-G.)
| | - Franck Rexand-Galais
- University of Angers, CLiPsy, SFR CONFLUENCES, F-49000 Angers, France; (A.V.); (F.R.-G.)
| |
Collapse
|
3
|
Muresu N, Puci MV, Sotgiu G, Sechi I, Usai M, Cossu A, Martinelli M, Cocuzza CE, Piana A. Diagnostic Accuracy of DNA-Methylation in Detection of Cervical Dysplasia: Findings from a Population-Based Screening Program. Cancers (Basel) 2024; 16:1986. [PMID: 38893107 PMCID: PMC11171015 DOI: 10.3390/cancers16111986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/17/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Epigenetic biomarkers in cancer have emerged as promising tools for early detection, prognosis, and treatment response prediction. In cervical cells, hypermethylation of the host and viral HPV-genome increases with the severity of lesions, providing a useful biomarker in the triage of hr-HPV-positive women and during treatment. The present study focuses on evaluating the clinical performance of the FAM19A4/miR124-2 methylation test in a population-based cervical screening program. METHODS Previously collected cervical samples, after bisulfite-converted DNA, were analyzed by PreCursor-M+ kit (distributed by Fujirebio Europe), for DNA methylation. The sensitivity, specificity, and negative/positive predictive values of DNA methylation were compared to histology, colposcopy, the HPV-DNA test, and cytology results. RESULTS Among the 61-sample set, the specificity of methylation vs. positive histology (≥CIN2) and colposcopy (≥G2) were 87% and 90%, whereas the sensitivity was 50% and 33.3%, respectively. The combination of methylation analysis with standard methods increases diagnostic accuracy. CONCLUSIONS Overall, we found a good specificity of DNA methylation in comparison to currently used techniques. Further larger studies could support the use of FAM19A4/miR124-2 as reliable biomarkers in the prevention of cervical cancer as triage in the screening protocol.
Collapse
Affiliation(s)
- Narcisa Muresu
- Department of Humanities and Social Science, University of Sassari, 07100 Sassari, Italy;
| | - Mariangela V. Puci
- Clinical Epidemiology and Medical Statistics Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (M.V.P.); (G.S.)
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (M.V.P.); (G.S.)
| | - Illari Sechi
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (I.S.); (A.C.); (A.P.)
| | - Manuela Usai
- Department of Humanities and Social Science, University of Sassari, 07100 Sassari, Italy;
| | - Andrea Cossu
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (I.S.); (A.C.); (A.P.)
| | - Marianna Martinelli
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (M.M.); (C.E.C.)
| | | | - Andrea Piana
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (I.S.); (A.C.); (A.P.)
| |
Collapse
|
4
|
Hernández-Silva CD, Ramírez de Arellano A, Pereira-Suárez AL, Ramírez-López IG. HPV and Cervical Cancer: Molecular and Immunological Aspects, Epidemiology and Effect of Vaccination in Latin American Women. Viruses 2024; 16:327. [PMID: 38543693 PMCID: PMC10974876 DOI: 10.3390/v16030327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/31/2024] [Accepted: 02/03/2024] [Indexed: 05/23/2024] Open
Abstract
Cervical cancer is primarily caused by Human Papillomavirus (HPV) infection and remains a significant public health concern, particularly in Latin American regions. This comprehensive narrative review addresses the relationship between Human Papillomavirus (HPV) and cervical cancer, focusing on Latin American women. It explores molecular and immunological aspects of HPV infection, its role in cervical cancer development, and the epidemiology in this region, highlighting the prevalence and diversity of HPV genotypes. The impact of vaccination initiatives on cervical cancer rates in Latin America is critically evaluated. The advent of HPV vaccines has presented a significant tool in combating the burden of this malignancy, with notable successes observed in various countries, the latter due to their impact on immune responses. The review synthesizes current knowledge, emphasizes the importance of continued research and strategies for cervical cancer prevention, and underscores the need for ongoing efforts in this field.
Collapse
Affiliation(s)
- Christian David Hernández-Silva
- Departamento de Microbiología y Patología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico; (C.D.H.-S.); (A.L.P.-S.)
| | - Adrián Ramírez de Arellano
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico;
| | - Ana Laura Pereira-Suárez
- Departamento de Microbiología y Patología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico; (C.D.H.-S.); (A.L.P.-S.)
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico;
| | - Inocencia Guadalupe Ramírez-López
- Departamento de Ciencias de La Salud, CUValles, Universidad de Guadalajara, Guadalajara-Ameca Rd Km. 45.5, Ameca 46600, Jalisco, Mexico
| |
Collapse
|
5
|
Aimagambetova G, Atageldiyeva K, Marat A, Suleimenova A, Issa T, Raman S, Huang T, Ashimkhanova A, Aron S, Dongo A, Iztleuov Y, Shamkeeva S, Azizan A. Comparison of diagnostic accuracy and acceptability of self-sampling devices for human Papillomavirus detection: A systematic review. Prev Med Rep 2024; 38:102590. [PMID: 38283967 PMCID: PMC10821625 DOI: 10.1016/j.pmedr.2024.102590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/28/2023] [Accepted: 01/02/2024] [Indexed: 01/30/2024] Open
Abstract
Objective Cervical cancer screening coverage remains low in many countries worldwide. Self-sampling approach for cervical cancer screening has a good potential to improve the screening coverage. This study aims to compare different types of HPV self-sampling devices for cervical cancer screening to identify the most accurate and acceptable device(s). Methods A systematic review was performed on data extracted from all studies specific to HPV self-sampling devices by searching relevant articles in PubMed, Google Scholar, Scopus, Web of Science, ScienceDirect, Cochrane Library, and EBSCO published from 2013 to October 2023. The study was registered in PROSPERO (CRD42022375682). Results Overall, 70 papers met the eligibility criteria for this systematic review and were included in the analysis: 22 studies reported self-sampling devices diagnostic accuracy, 32 studies reported self-sampling devices acceptability and 16 studies reported both (accuracy and acceptability). The most popular self-sampling devices were Evalyn Brush, FLOQ Swab, Cervex-Brush, and Delphi Screener. Out of overall 38 studies analyzing self-sampling devices' diagnostic accuracy, 94.7% of studies reported that self-collected specimens provided sensitivity and specificity comparable with clinician-collected samples; acceptability of Evalyn Brush, FLOQ Swab, Delphi Screener, and Colli-Pee, varied between 84.2% and 100%. Conclusion The self-sampling approach has a good potential to increase cervical cancer screening coverage. Evalyn Brush, Cervex-Brush, FLOQ Swab, and Delphi Screener self-sampling devices for HPV detection were the most commonly utilized and found to be the most accurate, and patient-acceptable. HPV detection accuracy using these self-sampling devices had no significant difference compared to the sampling performed by healthcare providers.
Collapse
Affiliation(s)
- Gulzhanat Aimagambetova
- Department of Surgery, School of Medicine, Nazarbayev University, 010000, Astana, Kazakhstan
| | - Kuralay Atageldiyeva
- Department of Medicine, School of Medicine, Nazarbayev University, 010000, Astana, Kazakhstan
- Clinical Academic Department of Internal Medicine, CF “University Medical Center”, 10000 Astana, Kazakhstan
| | - Aizada Marat
- Department of Obstetrics and Gynecology #1, NJSC “Astana Medical University”, 010000, Astana, Kazakhstan
| | - Assem Suleimenova
- Kazakh National Institute of Oncology and Radiology, Almaty, Kazakhstan
| | - Torgyn Issa
- School of Medicine, Nazarbayev University, 010000, Astana, Kazakhstan
| | - Sarina Raman
- College of Osteopathic Medicine, Touro University Nevada, Henderson, Nevada, USA
| | - Timothy Huang
- College of Osteopathic Medicine, Touro University Nevada, Henderson, Nevada, USA
| | - Ayimkul Ashimkhanova
- Department of Medicine, School of Medicine, Nazarbayev University, 010000, Astana, Kazakhstan
- Department of Clinical Medicine, School of Medicine, Al Farabi University, Almaty, Kazakhstan
| | - Saida Aron
- School of Medicine, Nazarbayev University, 010000, Astana, Kazakhstan
| | - Andrew Dongo
- College of Osteopathic Medicine, Touro University Nevada, Henderson, Nevada, USA
| | - Yerbolat Iztleuov
- Medical Center, Marat Ospanov West-Kazakhstan Medical University, 030000, Aktobe, Kazakhstan
| | - Saykal Shamkeeva
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Leipzig University Hospital, 04103, Leipzig, Germany
| | - Azliyati Azizan
- College of Osteopathic Medicine, Touro University Nevada, Henderson, Nevada, USA
| |
Collapse
|