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.
宫颈癌仍是重要的公共卫生问题，在筛查覆盖率较低的地区尤为突出。本研究评估了自采样与7型HPV mRNA E6/E7检测在改善墨西哥转诊人群宫颈癌筛查效果中的作用。研究纳入418名25-65岁墨西哥女性，这些参与者因细胞学检查结果异常（ASC-US及以上）被转诊进行阴道镜及活检。自采样标本同时采用14型HPV DNA检测和7型HPV mRNA E6/E7检测进行分析。研究评估了两种检测方法对CIN3+病变的敏感性、特异性、阳性预测值及所需阴道镜检查数量，并通过问卷调查评估了参与者对自采样的接受度。结果显示，7型HPV mRNA E6/E7检测在保持同等敏感性的同时，对CIN3+检测的特异性（77.0%）和阳性预测值显著高于14型HPV DNA检测（特异性：45.8%，p<0.001）。采用HPV mRNA检测作为分流工具后，每检出1例CIN3+病例所需的阴道镜检查数量从16.6例降至7.6例（p<0.001）。自采样获得参与者高度认可，多数受访者表示对操作过程有信心、不适感轻微，并愿意在家中进行自采样。自采样结合7型HPV mRNA E6/E7检测通过提升筛查可及性并确保诊断精确度，为优化宫颈癌筛查提供了可行策略。推广该方法可显著降低宫颈癌发病率和死亡率，在医疗服务不足人群中效果尤为显著。未来研究应重点关注将该方法纳入国家筛查规划的长期影响，并探索大规模实施的成本效益。
肿瘤(癌症)患者之家