New strategies to improve cervical cancer screening
Our team strive to raise the public awareness of cervical cancer and preventive health-seeking behaviour. Our projects enhance the community engagement and increase dissemination of concept and habit of cervical cancer screening to the group who are reluctant to screening.
In Hong Kong, the Guidelines for Cervical Cancer Prevention of The Hong Kong College of Obstetricians and Gynaecologists (HKCOG) were revised in 2016, providing information on the use of HPV testing as a standalone test or as part of ‘co-test’ with cytology for primary cervical cancer screening. Incorporating HPV testing into screening strategies not only to increase the length of screening interval but its high sensitivity has the potential to increase disease detection. While HPV and cytology co-testing can be considered as an alternative to cytology alone for primary screening, HPV self-sampling could be a more cost-effective strategy in strengthening the healthcare systems. We therefore focus on alternative cervical cancer screening strategies with the adoption and implementation of Human Papillomavirus (HPV) DNA self-collection sampling to improve participation in cervical cancer screening.
In recent years, several countries worldwide have implemented the high-risk HPV testing with the option of self-sampling in primary cervical cancer screening at the national level. We are among the first to conduct study on the acceptability and feasibility of HPV self-sampling in the local population, and especially in the under-screened population in Hong Kong. This is an on-going project to keep track of the uptake rate of HPV self-sampling in local setting. Our findings suggested that HPV self-sampling as an alternative primary cervical cancer screening is feasible and acceptable among local women population, especially for those under-screened women. Thus, it could effectively increase screening coverage in Hong Kong.
Our studies not only focus on challenges to cervical cancer screening in the general population but also concern for the population with special health needs such as deaf women, ethnic minority community, particularly in-migrant workers etc whose utilization rate was comparatively low. Various reasons to the low uptake rate may involve language barriers, lack of knowledge and awareness, and fear of disclosure to others that may result in discrimination.
All of the data provide insights and support for evidence-based decisions in health policy making to incorporate HPV self-sampling strategies into the organised National Cervical Cancer Screening Programme as well as to increase public awareness of cervical cancer.