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 Health  Vol.8 No.7 , May 2016
A Pilot Study to Evaluate an Internet-Based Cervical Cancer Screening Model Based on Self-Sampling
Abstract: Background: Community based cervical cancer screening models using self-collection can effectively place the identification of who is positive in the hands of the patient. The key areas we have identified as critical are 1) education, 2) notification of screening opportunities, 3) registration, 4) submission of samples, 5) receiving results with an explanation, and 6) being advised where to receive evaluation and management from qualified healthcare personnel. Methods: Our primary objectives were to create, register, and pilot a website as a public platform for cervical cancer prevention for both city and rural, individual and organizational application. We selected two sites: Shenzhen City in China as the local city (individual participant) site, and Sangzhi County in Hunan Province as the remote (group management) site. The website was reviewable to all of China, but applications for screening and registration were open only to the women from the 2 pilot sites. In the local site, the women would first sign up (obtain a password) to view the website (www.mcareu.com), and then if they desired, they could register for screening using their true name and their state ID. After an offline confirmation of the address, the sampling kit would arrive. Results were available with additional education and guidance for care also on the website. Findings: 120,099 people nationwide visited the website in 27 months by the end of May, 2015, 1148 women from the sites registered at the website and 87.5% enrolled in the pilot trial. 72.3% of those testing positive returned for management. Virtually 100% of the registration/historical information was entered appropriately and 100% of the samples were handled properly. Interpretation: Web-based decision aids help patients through the uncertainties of healthcare. Applied to cervical cancer screening using self-collection, the effectiveness of the model specifically in respect to accessibility, education, registration, data input, and instructions for positive management was clearly demonstrated by this pilot as well as the potential for future diagnostics applicable to self-collection.
Cite this paper: Wu, R. , Qu, X. , Du, H. , Liu, Z. , Hu, Q. , Wang, C. , Zhang, L. , Zhao, J. , Wang, G. , Belinson, J. (2016) A Pilot Study to Evaluate an Internet-Based Cervical Cancer Screening Model Based on Self-Sampling. Health, 8, 672-679. doi: 10.4236/health.2016.87071.
References

[1]   Wright, T.C., Denny, L., Kuhn, L., Pollack, A. and Lorincz, A. (2000) DNA Testing of Self-Collected Vaginal Samples Compared with Cytologic Screening to Detect Cervical Cancer. JAMA, 283, 81-86.
http://dx.doi.org/10.1001/jama.283.1.81

[2]   Belinson, J.L., Qiao, Y.L., Pretorius, R.G., et al. (2001) Shanxi Province Cervical Cancer Screening Study: A Cross-Sectional Comparative Trial of Multiple Techniques to Detect Cervical Intraepithelial Neoplasia. Gynecologic Oncology, 83, 439-444.
http://dx.doi.org/10.1006/gyno.2001.6370

[3]   Belinson, J.L., Qiao, Y.L., Pretorius, R.G., et al. (2003) Shanxi Province Cervical Cancer Screening Study II: Self-Sampling for High-Risk Human Papillomavirus Compared to Direct Sampling for HPV and Liquid Based Cervical Cytology. International Journal of Gynecological Cancer, 13, 1-8.
http://dx.doi.org/10.1111/j.1525-1438.2003.13611.x

[4]   Szarewski, A., Cadman, L., Mallett, S., et al. (2007) Human Papillomavirus Testing by Self-Sampling: Assessment of Accuracy in an Unsupervised Clinical Setting. Journal of Medical Screening, 14, 34-42.
http://dx.doi.org/10.1258/096914107780154486

[5]   Salmerón, J., Lazcano-Ponce, E., Lorincz, A., et al. (2003) Comparison of HPV-Based Assays with Papanicolaou Smears for Cervical Cancer Screening in Morelos State, Mexico. Cancer Causes & Control, 14, 505-512.
http://dx.doi.org/10.1023/A:1024806707399

[6]   Belinson, J.L., Hu, S., Niyazi, M., et al. (2010) Prevalence of Type-Specific Human Papillomavirus in Endocervical, Upper and Lower Vaginal, Perineal, and Vaginal Self-Collected Specimens: Implications for Vaginal Self-Collection. International Journal of Gynecological Cancer, 127, 1151-1157.
http://dx.doi.org/10.1002/ijc.25144

[7]   Gravitt, P.E., Belinson, J.L., Salmeron, J. and Shah, K.V. (2011) Looking Ahead: A Case for HPV Testing of Self- Sampled Vaginal Specimens 1 as a Cervical Cancer Screening Strategy. International Journal of Cancer, 129, 517- 527.
http://dx.doi.org/10.1002/ijc.25974

[8]   Belinson, J.L., Du, H., Yang, B., et al. (2012) Improved Sensitivity of Vaginal Self-Collection and High-Risk Human Papillomavirus Testing. International Journal of Cancer, 130, 1855-1860.
http://dx.doi.org/10.1002/ijc.26202

[9]   Belinson, J.L., Wang, G.X., Qu, X.F., et al. (2014) The Development and Evaluation of a Community Based Model for Cervical Cancer Screening Based on Self-Sampling. Gynecologic Oncology, 132, 636-642.
http://dx.doi.org/10.1016/j.ygyno.2014.01.006

[10]   Levinson, K.L., Abuelo, C., Chyung, E., et al. (2013) The Peru Cervical Cancer Prevention Study (PERCAPS): Community-Based Participatory Research in Manchay, Peru. International Journal of Gynecological Cancer, 23, 141-147.
http://dx.doi.org/10.1097/IGC.0b013e318275b007

[11]   Abuelo, C.E., Levinson, K.L., Salmeron, J., et al. (2013) The Peru Cervical Cancer Screening Study (PERCAPS): The Design and Implementation of a Mother/Daughter Screen, Treat, and Vaccinate Program in the Peruvian Jungle. Journal of Community Health, (EPUB Ahead of Print).

[12]   Tisci, S.E., Shen, Y.H., Fife, D., Goycoolea, J.M., Ma, C.P., Qiao, Y.L. and Belinson, J.L. (2003) Patient Acceptance of Self-Sampling for Human Papillomavirus in Rural China. Journal of Lower Genital Tract Disease, 7, 107-116.
http://dx.doi.org/10.1097/00128360-200304000-00007

[13]   Arriba, L.N., Enerson, C.L., Belinson, S., Novick, L. and Belinson, J. (2010) Mexican Cervical Cancer Screening Study II: Acceptability of Human Papillomavirus Self-Sampler. International Journal of Gynecological Cancer, 20, 1415-1423.

[14]   Gok, M., Heideman, D.A., van Kemenade, F.J., et al. (2012) Offering Self-Sampling for Human Papillomavirus Testing to Non-Attendees of the Cervical Screening Program: Characteristics of the Responders. European Journal of Cancer, 48, 1799-1808.
http://dx.doi.org/10.1016/j.ejca.2011.11.022

[15]   Virtanen, A., Anttila, A., Luostarinen, T., Malila, N. and Nieminen, P. (2015) Improving Cervical Cancer Screening Attendance in Finland. International Journal of Cancer, 136, 677-684.
http://dx.doi.org/10.1002/ijc.29176

[16]   He, J., Zhao, P. and Chen, W.Q. (2012) Chinese Cancer Registry Annual Report. Military Medical Science Press, Beijing.

[17]   Abramowicz, M., Zuccotti, G. and Pflomm, J.M. (2014) A Stool DNA Test (Cologuard) for Colorectal Cancer Screening. The Medical Letter on Drugs and Therapeutics, 56, 100-101.

[18]   Hui, D., Wang, G., Zhang, W., et al. (2014) To Evaluate the Sensitivity of Cobas 4800 HPV Test and Seq HPV Test in Detecting Vaginal Self-Samples in Screening. 29th International Papillomavirus Conference and Public Health & Clinical Workshops, Seattle, 21-25 August 2014, 97.

[19]   Trikalinos, T.A., Wieland, L.S., Adam, G.P., Zgodic, A. and Ntzani, E.E. (2014) Deci-sion Aids for Cancer Screening and Treatment. Report No. 15-EHC002-EF, AHRQ Comparative Effectiveness Reviews, Agency for Healthcare Research and Quality (US), Rockville.

[20]   Brackett, C.D. and Kearing, S. (2015) Use of a Web-Based Survey to Facilitate Shared Decision Making for Patients Eligible for Cancer Screening. The Patient: Patient-Centered Outcomes Research, 8, 171-177.

[21]   Stacy, D., Samant, R. and Bennett, C. (2008) Decision Making in Oncology: A Review of Patient Decision Aids to Support Patient Participation. CA: A Cancer Journal for Clinicians, 58, 293-304.
http://dx.doi.org/10.3322/CA.2008.0006

[22]   Lau, K.Y., Caverly, T.J., Cherng, S.T., Cao, P., West, M., Arenberg, D. and Meza, R. (2014) Development and Validation of a Personalized, Web-Based Decision Aid for Lung Cancer Screening Using Mixed Methods: A Study Protocol. JMIR Research Protocols, 3, e78.
http://www.researchprotocols.org/2014/4/e78/
http://dx.doi.org/10.2196/resprot.4039


[23]   Lee, H.Y., Koopmeiners, J.S., Rhee, T.G., Raveis, V.H. and Ahluwalia, J.S. (2014) Mobile Phone Text Messaging Intervention for Cervical Cancer Screening: Changes in Knowledge and Behavior Pre-Post Intervention. Journal of Medical Internet Research, 16, e196.

[24]   Nelson, E.J., Hughes, J., Oakes, J.M., Thyagarajan, B., Pankow, J.S. and Kulasingam, S.L. (2015) Human Papillomavirus Infection in Women Who Submit Self-Collected Vaginal Swabs after Internet Recruitment. Journal of Community Health, 40, 379-386.

[25]   Gustavsson, I., Sanner, K.F., Lindell, M.F., et al. (2011) Type-Specific Detection of High-Risk Human Papillomavirus (HPV) in Self-Sampled Cervicovaginal Cells Applied to FTA Elute Cartridge. Journal of Clinical Virology, 51, 255-258.
http://dx.doi.org/10.1016/j.jcv.2011.05.006

[26]   Luo, H.X., Du, H., Maurer, K., Belinson, J.L., Wang, G.X., Liu, Z.H., Zhang, L.J., Zhou, Y.Q, Wang, C., Tang, J.L., Qu, X.F. and Wu, R.F. (2016) An Evaluation of the Cobas4800 HPV Test on Cervico-Vaginal Specimens in Liquid versus Solid Transport Media. PLoS ONE, 11, e0148168.
http://dx.doi.org/10.1371/journal.pone.0148168

[27]   Levinson, K.L., Abuelo, C., Chyung, E., et al. (2013) The Peru Cervical Cancer Prevention Study (PERCAPS): The Technology to Make Screening Accessible. Gynecologic Oncology, 129, 318-323.
http://dx.doi.org/10.1016/j.ygyno.2013.01.026

[28]   Yi, X., Zou, J., Xu, J., et al. (2014) Development and Validation of a New HPV Genotyping Assay Based on Next Generation Sequencing. American Journal of Clinical Pathology, 141, 796-804.
http://dx.doi.org/10.1309/AJCP9P2KJSXEKCJB

 
 
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