The Japanese government recommends that adult females receive cervical cancer screening by Pap smear test every other year. However, according to the National Livelihood Survey in 2013, the coverage is only 32.7%. Recently the number of young Japanese women in their late 20s and 30s who get cervical cancer has been increasing. Izumo city in the western part of Japan started HPV co-testing for cervical cancer screening in 2007, much earlier than other municipalities. Adopting HPV co-testing showed successful results and there had been only few patients who needed extended hysterectomy. However, about half of the adult females did not receive the cervical cancer screening in the past 5 years, especially 60% of those in their late 20s and 30s. All cases with extended hysterectomy were from the non-attendees of screening in the past. Our ultimate aim is to improve the coverage of cervical cancer screening. In this study, we investigate if the self-sampling HPV test is an effective way to approach non-attendees and let them receive cervical cancer screening.
The target candidates of this study were women living in Izumo city, who were 25-year old to 45-years old, and who did not attend Izumo city’s cervical cancer screening in the past 5 years. In July 2015, we sent letters to let them know that they can receive free HPV tests at home using a self-sampling device. If they were willing, we sent them the HPV self-sampling device with a questionnaire on cervical cancer screening. In October we sent reminder letters to those who did not send back the self-collected sample and answered questionnaires. We used Evalyn Brush as the HPV self-collection device, and Hybrid Capture 2 (HC2) as the assay for high risk HPV DNA
Number of the candidate was 12,546. 2,120(16.9%) of them received the self-sampling HPV test, although 2806 of them wanted to receive self-sampling HPV test. 152 of attendee (7.2%) were HPV positive. 106 women of HPV positive received the Pap smear test by January in 2016. The result of Pap test was following; NILM(63), ASC-US(10), LSIL(24), HSIL(7), AIS(1), Improper sample(1). Almost all of participants of self-sampling HPV test answered that the result of self-sampling HPV test, especially HPV positive, could be good motivation to receive municipal cervical cancer screening using Pap test. 91.5% of participants thought that they would receive screening regularly if self-sampling test is available.
Although further analysis and research are needed, HPV test using self-sampling device is very useful and acceptable to non-attendees of the present cervical cancer screening with Pap smear test. It has the potential to improve the coverage of screening.