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Waller J, McCaffery K, Forrest S, Szarewski A, Cadman L, Austin J, Wardle J. Acceptability of unsupervised HPV self-sampling using written instructions. J Med Screen 2016; 13:208-13. [PMID: 17217611 DOI: 10.1177/096914130601300409] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives The study measured the acceptability of self-sampling for human papillomavirus (HPV) testing in the context of cervical cancer screening. Women carried out self-sampling unsupervised, using a written instruction sheet. Setting Participants were women attending either a family planning clinic or a primary care trust for routine cervical screening. Methods Women (n = 902) carried out self-sampling for HPV testing and then a clinician did a routine cervical smear and HPV test. Immediately after having the two tests, participants completed a measure of acceptability for both tests, and answered questions about ease of using the instruction sheet and willingness to use self-sampling in the future. Results The majority of women found self-sampling more acceptable than the clinician-administered test, but there was a lack of confidence that the test had been done correctly. Significant demographic differences in attitudes were found, with married women having more favourable attitudes towards self-sampling than single women, and Asian women having more negative attitudes than women in other ethnic groups. Intention to use self-sampling in the future was very high across all demographic groups. Conclusion Self-sampling for HPV testing was highly acceptable in this large and demographically diverse sample, and women were able to carry out the test alone, using simple written instructions. Consistent with previous studies, women were concerned about doing the test properly and this issue will need to be addressed if self-sampling is introduced. More work is needed to see whether the demographic differences we found are robust and to identify reasons for lower acceptability among single women and those from Asian background.
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Affiliation(s)
- J Waller
- Cancer Research UK Health Behaviour Unit, Department of Epidemiology and Public Health, UCL, London, UK.
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Cuzick J, Cuschieri K, Denton K, Hopkins M, Thorat M, Wright C, Cubie H, Moore C, Kleeman M, Austin J, Ashdown-Barr L, Hunt K, Cadman L. Performance of the Xpert HPV assay in women attending for cervical screening. Papillomavirus Research 2015. [PMCID: PMC5886845 DOI: 10.1016/j.pvr.2015.05.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objectives This study evaluated the Xpert HPV Assay in women attending screening in general practice by comparing Xpert with two established HPV tests, cytology and histology. Methods A prospective study in women aged 20–60 years attending screening in Bristol, Edinburgh and London using residual Preservcyt cytology samples. Sample order was randomised between Roche cobas4800 and Cepheid Xpert assays with Qiagen hc2 third. Results 3408 cases were included in the primary analysis. Positivity for Xpert was 19.6%, cobas 19.2% and hc2 19.9% with high concordance (kappa=86.8% vs cobas, 81.55 vs hc2). Xpert, cobas and hc2 showed similar sensitivity (98.7%, 97.5%, 98.7%) for CIN2+. All pairwise comparisons had high concordance (Kappa ≥0.78 with any abnormal cytology. Xpert and hc2 were positive for all cases of ≥moderate dyskaryosis (N=63)), cobas was negative in two. Histology was available for 172 participants. 79 reported CIN2+, 47 CIN3+. All CIN3+ was positive on Xpert and hc2 and one case negative for cobas. One case of CIN2 was negative for all assays. Conclusions The performance of Xpert HPV Assay in a general screening population is comparable to established HPV tests. It offers simplicity of testing, flexibility with non-batching of individual samples and rapid turnaround time. This is the first study to report on the performance of the Xpert HPV Assay in a screening population. Xpert HPV Assay׳s performance in detecting HPV is comparable to two clinically validated HPV tests. Xpert HPV Assay showed a relative sensitivity of 98.73% for CIN 2 or higher and 100% for CIN3 or higher.
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Affiliation(s)
- Jack Cuzick
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Charterhouse Square, London, EC1M 6BQ, United Kingdom
- Corresponding author.
| | - K. Cuschieri
- Scottish Human Papillomavirus Reference Laboratory, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, United Kingdom
| | - K. Denton
- Severn Pathology, Pathology Sciences Building, Southmead Hospital, Westbury-on-Trym, Bristol, BS10 5NB, United Kingdom
| | - M. Hopkins
- Specialist Virology Centre at Liverpool Clinical Laboratories, Royal Liverpool University Hospital, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, United Kingdom
| | - M.A. Thorat
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Charterhouse Square, London, EC1M 6BQ, United Kingdom
| | - C. Wright
- Pathology Department, Mint Wing, Imperial College Healthcare NHS Trust, St Mary׳s Hospital, Praed Street, Paddington, London W2 1NY, United Kingdom
| | - H. Cubie
- Scottish Human Papillomavirus Reference Laboratory, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, United Kingdom
| | - C. Moore
- Scottish Human Papillomavirus Reference Laboratory, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, United Kingdom
| | - M. Kleeman
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Charterhouse Square, London, EC1M 6BQ, United Kingdom
| | - J. Austin
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Charterhouse Square, London, EC1M 6BQ, United Kingdom
| | - L. Ashdown-Barr
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Charterhouse Square, London, EC1M 6BQ, United Kingdom
| | - K. Hunt
- Severn Pathology, Pathology Sciences Building, Southmead Hospital, Westbury-on-Trym, Bristol, BS10 5NB, United Kingdom
| | - L. Cadman
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Charterhouse Square, London, EC1M 6BQ, United Kingdom
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Forrest S, McCaffery K, Waller J, Desai M, Szarewski A, Cadman L, Wardle J. Attitudes to self-sampling for HPV among Indian, Pakistani, African-Caribbean and white British women in Manchester, UK. J Med Screen 2005; 11:85-8. [PMID: 15153323 PMCID: PMC4109398 DOI: 10.1258/096914104774061065] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objective: To examine attitudes to self-sampling for human
papillomavirus (HPV) testing among women from contrasting ethnic groups. Setting: Manchester, UK. Methods: Two hundred women of Indian, Pakistani, African-Caribbean and
white British origin were recruited from social and community groups to participate
in a questionnaire survey. The questionnaire included items on attitudes to
self-sampling and intention to use the test. Results: Willingness to try to use the test was high, and women did not
foresee religious or cultural barriers to self-sampling; however, a large proportion
of women were concerned about doing the test properly. This concern was greatest in
the Indian and African-Caribbean groups. Conclusions: Although women's willingness to try self-sampling for HPV
is encouraging, worries about carrying out the procedure correctly must be addressed
if women are to feel confident about the results of self-sampling methods and
reassured by a negative result.
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Affiliation(s)
- S Forrest
- Cancer Research UK Health Behaviour Unit, Department of Epidemiology & Public Health, University College London, London WC1E 6BT, UK
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Abstract
OBJECTIVES To assess the level and accuracy of public understanding of human papillomavirus (HPV) in the United Kingdom. METHODS Women attending a well woman clinic were asked to complete a questionnaire assessing HPV awareness and specific knowledge about the virus. RESULTS Questionnaires were completed by 1032 women, of whom 30% had heard of HPV. Older women, non-smokers, and those with a history of candida, genital warts, or an abnormal smear result were more likely to have heard of HPV. Even among those who had heard of HPV, knowledge was generally poor, and fewer than half were aware of the link with cervical cancer. There was also confusion about whether condoms or oral contraceptives could protect against HPV infection. CONCLUSIONS In this relatively well educated sample, awareness and knowledge of HPV were poor. Public education is urgently needed so that women participating in cervical cancer screening are fully informed about the meaning of their results, especially if HPV testing is soon to be introduced.
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Affiliation(s)
- J Waller
- Cancer Research UK Health Behaviour Unit, Department of Epidemiology and Public Health, UCL, 2-16 Torrington Place, London WC1E 6BT, UK.
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Cadman L, Findlay A. Assessing practice nurses' change in nutrition knowledge following training from a primary care dietitian. J R Soc Promot Health 1998; 118:206-9. [PMID: 10076668 DOI: 10.1177/146642409811800403] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The expanding role of the Primary Health Care Team (PHCT) has led to more opportunities to offer dietary advice to patients. However, members of the PHCT appear to lack nutritional knowledge and confidence when giving dietary advice. This work assesses the changes in Practice Nurses' (PNs) nutrition knowledge and confidence when giving dietary advice to patients, following training from a dietitian. Base line nutrition knowledge of PNs and their confidence when giving dietary advice was assessed in 30 GP Practices by questionnaire. Following Practice-based training from a dietitian, change in knowledge and confidence was assessed using the same questionnaire. Paired and unpaired analysis was carried out on the PN's knowledge and confidence scores respectively. Nutrition knowledge increased significantly after training. The mean difference (95% confidence interval) pre- and post-training was 11.6 (7.8, 15.4). After training 88% of PNs reported having good or excellent confidence compared with 27% before training (chi-squared test p < 0.001). Nutrition training from a dietitian improves nutrition knowledge of PNs. It also improves their confidence and is recommended to support their role in providing accurate and consistent dietary advice to patients.
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Affiliation(s)
- L Cadman
- Nutrition and Dietetic Services, Dorset Health Care, NHS Trust, Bournemouth
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