Abstract
In the present study, we compared the positive cytodiagnostic test rates with discrepancies using self-collection devices for cervical cancer screening. We made this survey to examine whether or not our self- smear preparation method using the Kato self-collection device contributed to an improved rate of detecting atypical cells compared with existing recommended preparation methods. Specimens were collected at 14 facilities handling self-collection methods, and samples were collected by a physician in 2 facilities. The chi- squared test was performed using the SPSS ver. 20 statistical software to determine the relationships between the positive cytodiagnostic rate, specimen preparation methods, and self-collection devices. Collecting cells using the Kato self-collection device and preparing liquid-based specimens, we obtained a significantly higher rate of positive cytodiagnosis and our results were equal to those obtained with the direct method. Taking into consideration increased needs for screening using the self-collection method in future, with even more improved test accuracy, a screening test that is acceptable to society needs to be established.
Highlights
Cytodiagnostic screening methods are highly accurate and are widely used in the diagnosis of cervical cancer (Aoki et al, 2012)
At the 11 facilities dealing with selfcollected specimens, the positive cytodiagnostic rate was 0.00%-1.44%, with the majority showing a rate of approximately 0.5%
The Kato self-collection devise showed a high positive cytodiagnostic rate compared with general self-collection methods, similar to those in facilities where samples were collected by physicians
Summary
Cytodiagnostic screening methods are highly accurate and are widely used in the diagnosis of cervical cancer (Aoki et al, 2012). The extremely low average of screening rate in Japan (23%) is a growing concern (WHO/ICO Information Center, 2010). To overcome the existing low screening rate in Japan, awareness-raising activities such as distribution of free-screening vouchers have been carried out to publicize the importance of cervical cancer screening. New measures to raise the cervical cancer screening rate have included a drive to initiate cytodiagnostic testing by distributing self-collection devices and physicians directly collecting cervical swabs from patients. The accuracy of cytodiagnostic tests through self-collection is much lower than the direct method because the absolute number of cells on the smear is low and reports have indicated that there are several defective specimens due to sampling errors (Belinson et al, 2001; Belinson etal., 2003; Garcia et al, 2003; Salmerón et al, 2003). Despite the awareness regarding the disadvantage of the selfcollection method, several women prefer this method because it is convenient, and because they are either embarrassed or do not have time to visit a hospital
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