Abstract
Background: Japan has an extremely low rate of participation in cervical cancer screening of approx. 30%. To promote participation, many companies and health insurance associations have adopted a cytological self-sampling method, instead of evidence-based physician-sampling.
Objectives: The purpose of this study is to evaluate the usefulness of the cytological self-sampling method in population-based health check-up programs for employees and their family members.
Subjects: Physician-collected and self-collected samples from 61,489 and 5,927 women, respectively, who participated in cervical cancer screening at Kyoto Industrial Health Association from April 1, 2013 through March 31, 2015 were evaluated.
Method: Samples were classified into two groups- an employee group and a family member group. Cytological positive rates in both groups were compared and evaluated according to age using Fisher’s exact test.
Results: In both groups, cytological positive rates of physician-collected samples were higher, and a significant difference (p<0.01) was observed. No glandular cell lesions were detected in self-collected samples.
Discussion: According to the above results, self-sampling showed a lower accuracy in health check-ups for employees and their family members. False negative results were frequently obtained with the self-sampling method, especially in women 20-40 years old, the peak age range of cervical cancer onset, responsible for reduced fertility, and decreased quality of life. This study also indicated that self-sampling may not be suitable as a detection method for cervical adenocarcinoma, which is also on the rise. Self-sampling HPV testing has recently been reported as an effective alternative to physician-sampling testing, and is expected to serve as an alternative method.
Conclusion: Companies and health insurance associations should not adopt the cytological self-sampling method for cervical cancer screening.
