Self-sampling and HPV DNA testing for cervical precancer screening in a cohort of nuns in Ghana: a cross-sectional cohort studyResearch in context
Summary: Background: The need for cervical cancer screening has been emphasised in at-risk cohorts of women to reduce their risk of cervical cancer. Some women with decreased risk of acquiring human papillomavirus (HPV) infections, such as Catholic nuns, receive less attention and on occasion are m...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-09-01
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| Series: | EClinicalMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537023003607 |
| _version_ | 1797727646552948736 |
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| author | Kofi Effah Ethel Tekpor Joseph Emmanuel Amuah Nana Owusu M. Essel Seyram Kemawor Esu Aku Catherine Morkli Esther Lamptey–Mills Comfort Mawusi Wormenor Lawrencia Serwaa Manu Gifty Belinda Klutsey Stephen Danyo Patrick Kafui Akakpo |
| author_facet | Kofi Effah Ethel Tekpor Joseph Emmanuel Amuah Nana Owusu M. Essel Seyram Kemawor Esu Aku Catherine Morkli Esther Lamptey–Mills Comfort Mawusi Wormenor Lawrencia Serwaa Manu Gifty Belinda Klutsey Stephen Danyo Patrick Kafui Akakpo |
| author_sort | Kofi Effah |
| collection | DOAJ |
| description | Summary: Background: The need for cervical cancer screening has been emphasised in at-risk cohorts of women to reduce their risk of cervical cancer. Some women with decreased risk of acquiring human papillomavirus (HPV) infections, such as Catholic nuns, receive less attention and on occasion are missed in cervical cancer screening programmes. This study aimed to determine the high-risk HPV (hr-HPV) prevalence in such a cohort to emphasise the need for cervical precancer screening among all women. To improve compliance, we employed self-sampling. Methods: This descriptive cross-sectional cohort study involved the data of 105 Catholic nuns subjected to cervical screening using self-samples in the Greater Accra, Volta, and Central regions of Ghana between June 4, 2022 and June 30, 2022. hr-HPV testing was performed on self-samples using the MA-6000 HPV DNA platform. Screen-positive nuns underwent follow-up pap smears and EVA colposcopy. In addition to descriptive analysis, univariate and multivariable nominal logistic regression was used to explore the relationship between hr-HPV positivity and selected continuous and categorical factors. Findings: 105 nuns from three convents were screened with hr-HPV DNA testing (MA-6000). Twenty-five tested positive for hr-HPV (prevalence of 23.8% (95% CI, 15.7–32.0) [HPV 18 only (n = 2, 1.9%), non-HPV 16/18 genotypes (others) (n = 22, 21.0%), and mixed infection with HPV 16 and other genotype(s) (n = 1, 1.0%)]. Pap smears for all 25 hr-HPV-positives came in as negative for intraepithelial lesions or malignancy, whereas EVA mobile colposcopy showed minor abnormal findings in two (8.0%; 95% CI, 1.0–26.0), both of whom were managed conservatively. Interpretation: Our findings suggest that the hr-HPV prevalence in this cohort of nuns is similar to that of the general population. To meet the World Health Organization's target for cervical cancer elimination, it is important that all women are given access to cervical cancer screening and preventative services. Further, increasing ‘anonymity’ and privacy among nuns through self-sampling may be crucial to expanding choice, coverage, and uptake of screening in support of their health rights. Funding: None. |
| first_indexed | 2024-03-12T11:02:33Z |
| format | Article |
| id | doaj.art-7af3bb6946ac4848b73c652820edc072 |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-03-12T11:02:33Z |
| publishDate | 2023-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-7af3bb6946ac4848b73c652820edc0722023-09-02T04:32:12ZengElsevierEClinicalMedicine2589-53702023-09-0163102183Self-sampling and HPV DNA testing for cervical precancer screening in a cohort of nuns in Ghana: a cross-sectional cohort studyResearch in contextKofi Effah0Ethel Tekpor1Joseph Emmanuel Amuah2Nana Owusu M. Essel3Seyram Kemawor4Esu Aku Catherine Morkli5Esther Lamptey–Mills6Comfort Mawusi Wormenor7Lawrencia Serwaa Manu8Gifty Belinda Klutsey9Stephen Danyo10Patrick Kafui Akakpo11Cervical Cancer Prevention and Training Centre, Catholic Hospital, Battor, Ghana; Department of Obstetrics and Gynecology, Catholic Hospital, Battor, GhanaCervical Cancer Prevention and Training Centre, Catholic Hospital, Battor, GhanaCervical Cancer Prevention and Training Centre, Catholic Hospital, Battor, Ghana; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, CanadaCervical Cancer Prevention and Training Centre, Catholic Hospital, Battor, Ghana; Department of Emergency Medicine, College of Health Sciences, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada; Corresponding author. Department of Emergency Medicine, Faculty of Medicine and Dentistry, College of Health Sciences, University of Alberta, 730 University Terrace, Edmonton, AB, T6G 2T4, Canada.Cervical Cancer Prevention and Training Centre, Catholic Hospital, Battor, GhanaCervical Cancer Prevention and Training Centre, Catholic Hospital, Battor, GhanaDepartment of Obstetrics and Gynecology, Cape Coast Teaching Hospital, Cape Coast, GhanaCervical Cancer Prevention and Training Centre, Catholic Hospital, Battor, GhanaDepartment of Obstetrics and Gynecology, Catholic Hospital, Battor, Ghana; Department of Obstetrics and Gynecology, Korle Bu Teaching Hospital, Accra, GhanaCervical Cancer Prevention and Training Centre, Catholic Hospital, Battor, GhanaCervical Cancer Prevention and Training Centre, Catholic Hospital, Battor, GhanaDepartment of Pathology, School of Medical Sciences, University of Cape Coast, Cape Coast, GhanaSummary: Background: The need for cervical cancer screening has been emphasised in at-risk cohorts of women to reduce their risk of cervical cancer. Some women with decreased risk of acquiring human papillomavirus (HPV) infections, such as Catholic nuns, receive less attention and on occasion are missed in cervical cancer screening programmes. This study aimed to determine the high-risk HPV (hr-HPV) prevalence in such a cohort to emphasise the need for cervical precancer screening among all women. To improve compliance, we employed self-sampling. Methods: This descriptive cross-sectional cohort study involved the data of 105 Catholic nuns subjected to cervical screening using self-samples in the Greater Accra, Volta, and Central regions of Ghana between June 4, 2022 and June 30, 2022. hr-HPV testing was performed on self-samples using the MA-6000 HPV DNA platform. Screen-positive nuns underwent follow-up pap smears and EVA colposcopy. In addition to descriptive analysis, univariate and multivariable nominal logistic regression was used to explore the relationship between hr-HPV positivity and selected continuous and categorical factors. Findings: 105 nuns from three convents were screened with hr-HPV DNA testing (MA-6000). Twenty-five tested positive for hr-HPV (prevalence of 23.8% (95% CI, 15.7–32.0) [HPV 18 only (n = 2, 1.9%), non-HPV 16/18 genotypes (others) (n = 22, 21.0%), and mixed infection with HPV 16 and other genotype(s) (n = 1, 1.0%)]. Pap smears for all 25 hr-HPV-positives came in as negative for intraepithelial lesions or malignancy, whereas EVA mobile colposcopy showed minor abnormal findings in two (8.0%; 95% CI, 1.0–26.0), both of whom were managed conservatively. Interpretation: Our findings suggest that the hr-HPV prevalence in this cohort of nuns is similar to that of the general population. To meet the World Health Organization's target for cervical cancer elimination, it is important that all women are given access to cervical cancer screening and preventative services. Further, increasing ‘anonymity’ and privacy among nuns through self-sampling may be crucial to expanding choice, coverage, and uptake of screening in support of their health rights. Funding: None.http://www.sciencedirect.com/science/article/pii/S2589537023003607NunsHuman papillomavirus DNA testingSelf samplingCervical cancerCervical precancer screening |
| spellingShingle | Kofi Effah Ethel Tekpor Joseph Emmanuel Amuah Nana Owusu M. Essel Seyram Kemawor Esu Aku Catherine Morkli Esther Lamptey–Mills Comfort Mawusi Wormenor Lawrencia Serwaa Manu Gifty Belinda Klutsey Stephen Danyo Patrick Kafui Akakpo Self-sampling and HPV DNA testing for cervical precancer screening in a cohort of nuns in Ghana: a cross-sectional cohort studyResearch in context EClinicalMedicine Nuns Human papillomavirus DNA testing Self sampling Cervical cancer Cervical precancer screening |
| title | Self-sampling and HPV DNA testing for cervical precancer screening in a cohort of nuns in Ghana: a cross-sectional cohort studyResearch in context |
| title_full | Self-sampling and HPV DNA testing for cervical precancer screening in a cohort of nuns in Ghana: a cross-sectional cohort studyResearch in context |
| title_fullStr | Self-sampling and HPV DNA testing for cervical precancer screening in a cohort of nuns in Ghana: a cross-sectional cohort studyResearch in context |
| title_full_unstemmed | Self-sampling and HPV DNA testing for cervical precancer screening in a cohort of nuns in Ghana: a cross-sectional cohort studyResearch in context |
| title_short | Self-sampling and HPV DNA testing for cervical precancer screening in a cohort of nuns in Ghana: a cross-sectional cohort studyResearch in context |
| title_sort | self sampling and hpv dna testing for cervical precancer screening in a cohort of nuns in ghana a cross sectional cohort studyresearch in context |
| topic | Nuns Human papillomavirus DNA testing Self sampling Cervical cancer Cervical precancer screening |
| url | http://www.sciencedirect.com/science/article/pii/S2589537023003607 |
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