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Self-collection tools for routine cervical cancer screening: a review

Othman NH, Mohamad Zaki FH

Asian Pac J Cancer Prev, 2014;15(20):8563-9.
PMID: 25374168

Sub-optimal participation is a major problem with cervical cancer screening in developing countries which have no organized national screening program. There are various notable factors such as 'embarrassment', 'discomfort' and 'no time' cited by women as they are often also the bread winners for the family. Implementation of self-sampling methods may increase their participation. The aim of this article was to provide a survey of various types of self-sampling tools which are commonly used in collection of cervical cells. We reviewed currently available self-sampling devices and collated the advantages and disadvantages of each in terms of its acceptance and its accuracy in giving desired results. In general, regardless of which device is used, self-sampling for cervical scrapings is highly acceptable to women in most of the studies cited.
Self-sampling versus physician sampling for cervical cancer screening; The agreement of cytological diagnoses. [Abstract]

Mohamad Zaki FH, Nik Hussain NH, Ismail P, Wan Yusoff WZ, Othman NH

Pathology, 2016 Feb;48 Suppl 1:S148.
PMID: 27772923 DOI: 10.1016/j.pathol.2015.12.402

Background: The major problem with cervical cancer screening in countries which have no organized national screening program for cervical cancer is sub-optimal participation. Implementation of self-sampling method may increase the participation of women to screen for cervical cancer.
Aims: To determine the agreement of cytological diagnoses made on samples collected by women themselves (self-sampling) versus cytological diagnoses made on samples collected
by physicians (Physician sampling)
Methods: We invited women volunteers to undergo two procedures; cervical self-sampling using the Evalyn brush and physician scraping using Cervex brush. They women were
shown a video presentation on how to take their own cervical samples before the procedure. The samples taken by physicians were taken as per routine testing (Gold Standard). All
samples were subjected to Thin Prep monolayer smears. The diagnoses made were according to the Bethesda classification. The results from the two sampling methods were analysed and compared.
Results: A total of 367 women were recruited into the study. Thin Prep smears by physicians were better in terms of volume and variety of the cells seen. There is significant good agreement of the cytological diagnoses made on the samples from the two sampling methods with the Kappa value of 0.568 (p=0.040). The Thin Prep smears by self-sampling method were better in detecting microorganisms.
Conclusion: This study shows that samples taken by women themselves (self-sampling) and physicians sampling had good cytology agreement. Self-sampling could be the method of
choice in countries in which the coverage of women attending clinics for screening for cervical cancer is poor.
SelfSampling Versus Physicians' Sampling for Cervical Cancer Screening Agreement of Cytological Diagnoses

Othman NH, Zaki FH, Hussain NH, Yusoff WZ, Ismail P

Asian Pac J Cancer Prev, 2016;17(7):3489-94.
PMID: 27509997

BACKGROUND: A major problem with cervical cancer screening in countries which have no organized national screening program for cervical cancer is suboptimal participation. Implementation of selfsampling method may increase the coverage.
OBJECTIVE: We determined the agreement of cytological diagnoses made on samples collected by women themselves (selfsampling) versus samples collected by physicians (Physician sampling).
MATERIALS AND METHODS: We invited women volunteers to undergo two procedures; cervical selfsampling using the Evalyn brush and physician sampling using a Cervex brush. The women were shown a video presentation on how to take their own cervical samples before the procedure. The samples taken by physicians were taken as per routine testing (Gold Standard). All samples were subjected to Thin Prep monolayer smears. The diagnoses made were according to the Bethesda classification. The results from these two sampling methods were analysed and compared.
RESULTS: A total of 367 women were recruited into the study, ranging from 22 to 65 years age. There was a significant good agreement of the cytological diagnoses made on the samples from the two sampling methods with the Kappa value of 0.568 (p=0.040). Using the cytological smears taken by physicians as the gold standard, the sensitivity of selfsampling was 71.9% (95% CI:70.972.8), the specificity was 86.6% (95% CI:85.7 87.5), the positive predictive value was 74.2% (95% CI:73.375.1) and the negative predictive value was 85.1% (95% CI: 84.286.0). Selfsampling smears (22.9%) allowed detection of microorganisms better than physicians samples (18.5%).
CONCLUSIONS: This study shows that samples taken by women themselves (selfsampling) and physicians have good diagnostic agreement. Selfsampling could be the method of choice in countries in which the coverage of women attending clinics for screening for cervical cancer is poor.

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