1. Enhancing Cervical Cancer Screening with 7-Type HPV mRNA E6/E7 Testing on Self-Collected Samples: Multicentric Insights from Mexico.
- Author
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Flores, Carlos Eduardo Aranda, Falang, Bente Marie, Gómez-Laguna, Laura, Gutiérrez, Guillermo Gómez, León, Jorge Miguel Ortiz, Uribe, Miguel, Cruz, Omar, and Sørbye, Sveinung Wergeland
- Subjects
BIOPSY ,HEALTH services accessibility ,CERVIX uteri tumors ,EARLY detection of cancer ,QUESTIONNAIRES ,PAPILLOMAVIRUSES ,EVALUATION of medical care ,COLPOSCOPY ,MESSENGER RNA ,RESEARCH ,COLLECTION & preservation of biological specimens ,QUALITY assurance ,MOLECULAR diagnosis ,SENSITIVITY & specificity (Statistics) - Abstract
Simple Summary: This study explores an innovative approach to cervical cancer screening by employing a 7-type HPV mRNA E6/E7 test on self-collected samples from women in Mexico. It investigates whether this method can enhance the accuracy of diagnostics and increase acceptance among participants referred for colposcopy and biopsy due to abnormal cytology results (ASC-US+). The potential benefits include reducing the rate of cervical cancer and the need for unnecessary medical procedures, making screening more accessible and acceptable, especially in underserved areas. The findings could significantly influence the future practices of cervical cancer screening. Cervical cancer remains a significant public health issue, particularly in regions with low screening uptake. This study evaluates the effectiveness of self-sampling and the 7-type HPV mRNA E6/E7 test in improving cervical cancer screening outcomes among a referral population in Mexico. A cohort of 418 Mexican women aged 25 to 65, referred for colposcopy and biopsy due to abnormal cytology results (ASC-US+), participated in this study. Self-samples were analyzed using both the 14-type HPV DNA test and the 7-type HPV mRNA E6/E7 test. The study assessed the sensitivity, specificity, positive predictive value (PPV), and the necessity of colposcopies to detect CIN3+ lesions. Participant acceptability of self-sampling was also evaluated through a questionnaire. The 7-type HPV mRNA E6/E7 test demonstrated equivalent sensitivity but significantly higher specificity (77.0%) and PPV for CIN3+ detection compared to the 14-type HPV DNA test (specificity: 45.8%, p < 0.001). The use of the HPV mRNA test as a triage tool reduced the number of colposcopies needed per CIN3+ case detected from 16.6 to 7.6 (p < 0.001). Self-sampling was highly accepted among participants, with the majority reporting confidence in performing the procedure, minimal discomfort, and willingness to undertake self-sampling at home. Self-sampling combined with the 7-type HPV mRNA E6/E7 testing offers a promising strategy to enhance cervical cancer screening by improving accessibility and ensuring precise diagnostics. Implementing these app roaches could lead to a significant reduction in cervical cancer morbidity and mortality, especially in underserved populations. Future research should focus on the long-term impact of integrating these methods into national screening programs and explore the cost-effectiveness of widespread implementation. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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