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Effectiveness of cervicovaginal self sampling in screening of cervical cancer

Description: Cancer of the uterine cervix is still a large public health problem because of its high prevalence, despite the development of new screening techniques. In the female population of Brazil, cervical cancer is the second most common malignant neoplasia, behind only skin cancer (nonmelanoma), especially in poorer regions with less access to health care, with an estimated risk of 17 cases per 100 000 women. Among the reasons for the predominance of this cancer in the lower social class, the effort required for the patient to perform the screening with conventional Pap collection of cervicovaginal cytology stands out.Some countries have explored alternative methods for universalisation and facilitation of cervical cancer screening, such as self-collection, which can be performed using a sterile brush called Evalyn Brush (Rovers ®), costing aorund R$25 each. This method's sensitivity is high in some studies, but the amount of cervical cells collected may be fewer than in the conventional examination done by a health professional. On the other hand, it has the advantage of being less invasive, increasing the number of women screened and effectively including those who would be unable to participate in the conventional screening for several reasons, including emotional, physical and even socio-cultural-economic problems and can be applied both in prisons and in favelas. However, there is need for orientation and we still do not know what's the knowledge of the patients in our country about this method and hence its acceptance. Therefore, this study aims to assess the results of the vaginal self-collection in the screening of cervical cancer. Furthermore, we shall analyze the quality of the cervical material obtained by this technique and compare its acceptability against the collection performed by a healthcare professional. Moreover, cervical material will be collected for liquid cytology screening, DNA HPV test, p16/Ki-67 dual-stain cytology and colposcopy. Positive results will be confirmed via a cervix biopsy and histology result. This study will be conducted at the Division of Gynecology of the Department of Obstetrics and Gynecology at the Hospital das Clinicas of the Faculty of Medicine of the University of São Paulo (USP).The importance of this study is to corroborate, if the self-collection produces good results, that the method may be useful in screening for cervical cancer, and in that way, contributing to a decrease in incidence and mortality rates, especially in the poorer population of our country, bringing great advancements to public health (AU)

Funder: Fundação de Amparo à Pesquisa do Estado de São Paulo

Funding type: grant

Funder scheme: Auxílio à Pesquisa - Regular

Start date: 2017-05-01

End date: 2019-10-31

Investigator: José Maria Soares Junior

Institution: Universidade de São Paulo (USP). Faculdade de Medicina (FM)

Topic: Women's cancer prevention and management

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

Funded outputs count: 3