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Open Access 01-12-2023 | Human Papillomavirus | Research

Evaluation of self-sampling-based cervical cancer screening strategy using HPV Selfy CE-IVD test coupled with home-collection kit: a clinical study in Italy

Authors: Giulia Feltri, Giulio Valenti, Erica Isidoro, Jaspreett Kaur, Marianna Treleani, Aurora Bartelloni, Claudia Mauro, Federica Spiga, Giulia Ticich, Michela Di Napoli, Claudia Biagi, Maria Pachetti, Sandro Centonze, Santina Castriciano, Sara Zanchiello, Fabiola Giudici, Daniela Gerin, Fabrizio Zanconati

Published in: European Journal of Medical Research | Issue 1/2023

Abstract

Background

Primary human papillomaviruses (HPV) cervical cancer screening can be strengthened by offering home-collection of biological specimen as a valuable option to increase screening coverage. As recommended by World Health Organization (WHO), screening programs should consider whether the inclusion of HPV self-sampling as a complementary option within their existing screening algorithms could address the gaps in current coverage. However, few HPV screening tests are validated for self-sampling according to international guidelines. This study aimed to test a self-sampling-based screening strategy, complementary to the main screening program based on clinician-collected cervical samples. The study took place in Trieste, Italy, and it aimed to evaluate the feasibility of self-testing at home under an opt-in system during COVID-19 pandemic in order to exploit self-sampling to reduce the screening delay generated by the lockdown.

Methods

500 women, who should have received the screening call in 2020, were asked, via phone call, to participate in the study. To whom agreed, a home-collection kit, including a vaginal dry swab for specimen collection, was sent. The recipients performed the sample self-collection and sent back the swab through traditional mail using a prepaid envelope. Once received by the hospital, the samples were analyzed with HPV Selfy (Ulisse BioMed, Italy), a CE-IVD HPV screening test specifically validated for self-collection. Results were further compared using cobas^® 4800 HPV (Roche, Switzerland).

Results

80% women sent back their swab, showing one of the highest return rate obtained in comparable studies. 34 HPV-positive women were followed up and underwent the Pap test, that revealed 8 low squamous intraepithelial lesions (LSIL) cases, later triaged to colposcopy. HPV Selfy was confirmed to be an adequate test for self-sampling-based screening.

Conclusions

This study further confirmed the feasibility of self-test at home screening strategy based on self-sampling with an opt-in system as a support method to enhance cervical cancer screening coverage in Italy. Enrolled women showed a high appreciation for this approach. HPV Selfy test demonstrated to be a valuable assay for cervical cancer screening based on home self-collection.

Trial registration: ASUGI Trieste n. 16008/2018 and amendment 02-11/09/2020.

Available only for authorised users

Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021. https://doi.org/10.3322/caac.21660.CrossRefPubMed

Sankaranarayanan R, Thara S, Esmy PO, Basu P. Cervical cancer: Screening and therapeutic perspectives. Med Princ Pract. 2008;17(5):351–64. https://doi.org/10.1159/000141498.CrossRefPubMed

Crofts V, Flahault E, Tebeu PM, et al. Education efforts may contribute to wider acceptance of human papillomavirus self-sampling. Int J Womens Health. 2015;7:149–54. https://doi.org/10.2147/IJWH.S56307.CrossRefPubMedPubMedCentral

Gök M, Heideman DAM, Van Kemenade FJ, et al. Offering self-sampling for human papillomavirus testing to non-attendees of the cervical screening programme: characteristics of the responders. Eur J Cancer. 2012;48(12):1799–808. https://doi.org/10.1016/j.ejca.2011.11.022.CrossRefPubMed

Tranberg M, Bech BH, Blaakær J, Jensen JS, Svanholm H, Andersen B. Preventing cervical cancer using HPV self-sampling: direct mailing of test-kits increases screening participation more than timely opt-in procedures - a randomized controlled trial. BMC Cancer. 2018;18(1):1–11. https://doi.org/10.1186/s12885-018-4165-4.CrossRef

Haguenoer K, Sengchanh S, Gaudy-Graffin C, et al. Vaginal self-sampling is a cost-effective way to increase participation in a cervical cancer screening programme: a randomised trial. Br J Cancer. 2014;111(11):2187–96. https://doi.org/10.1038/bjc.2014.510.CrossRefPubMedPubMedCentral

Crosbie EJ, Einstein MH, Franceschi S, Kitchener HC. Human papillomavirus and cervical cancer. Lancet. 2013;370(13):890–907. https://doi.org/10.1016/S0140-6736(13)60022-7.CrossRef

ICO HPV Information Centre. Human Papillomavirus and Related Diseases Report. HPV Inf Cent. 2017;60.

https://apps.who.int/iris/rest/bitstreams/1280112/retrieve. Accessed 04 Sept 2022.

10.

Sechi I, Elvezia CC, Martinelli M, Muresu N, Castriciano S, Sotgiu G, Piana A. Comparison of different self-sampling devices for molecular detection of human papillomavirus (HPV) and other sexually transmitted infections (STIs): a pilot study. Healthcare. 2022;10(3):459. https://doi.org/10.3390/healthcare10030459.CrossRefPubMedPubMedCentral

11.

Saville M, Hawkes D, Keung MHT, Ip ELO, Silvers J, Sultana F, Malloy MJ, Velentzis LS, Canfel K, Wrede CD, Brotherton JML. Analytical performance of HPV assays on vaginal self-collected vs practitioner-collected cervical samples: the SCoPE study. J Clin Virol. 2020;127:104375.CrossRefPubMed

12.

Viviano M, Willame A, Cohen M, Benski AC, Catarino R, Wuillemin C, Tran PL, Petignat P, Vassilakos P. A comparison of cotton and flocked swabs for vaginal self-sample collection. Int J Womens Health. 2018;15(10):229–36. https://doi.org/10.2147/IJWH.S157897.CrossRef

13.

Verdoodt F, Jentschke M, Hillemanns P, Racey CS, Snijders PJF, Arbyn M. Reaching women who do not participate in the regular cervical cancer screening programme by offering self-sampling kits: a systematic review and meta-analysis of randomised trials. Eur J Cancer. 2015;51(16):2375–85. https://doi.org/10.1016/j.ejca.2015.07.006.CrossRefPubMed

14.

Szarewski A, Cadman L, Mesher D, et al. HPV self-sampling as an alternative strategy in non-attenders for cervical screening- a randomised controlled trial. Br J Cancer. 2011;104(6):915–20. https://doi.org/10.1038/bjc.2011.48.CrossRefPubMedPubMedCentral

15.

Snijders PJF, Verhoef VMJ, Arbyn M, et al. High-risk HPV testing on self-sampled versus clinician-collected specimens: a review on the clinical accuracy and impact on population attendance in cervical cancer screening. Int J Cancer. 2013;132(10):2223–36. https://doi.org/10.1002/ijc.27790.CrossRefPubMed

16.

Inturrisi F, Aitken CA, Melchers WJG, van den Brule AJC, Molijn A, Hinrichs JWJ, Niesters HGM, Siebers AG, Schuurman R, Heideman DAM, de Kok IMCM, Bekkers RLM, van Kemenade FJ, Berkhof J. Clinical performance of high-risk HPV testing on self-samples versus clinician samples in routine primary HPV screening in the Netherlands: an observational study. Lancet Reg Health Eur. 2021;11:100235. https://doi.org/10.1016/j.lanepe.2021.100235.CrossRefPubMedPubMedCentral

17.

Jalili F, O’Conaill C, Templeton K, Lotocki R, Fischer G, Manning L, Cormier K, Decker K. Assessing the impact of mailing self-sampling kits for human papillomavirus testing to unscreened non-responder women in Manitoba. Curr Oncol. 2019;26(3):167–72. https://doi.org/10.3747/co.26.4575.CrossRefPubMedPubMedCentral

18.

Sormani J, Kenfack B, Wisniak A, Moukam Datchoua A, Lemoupa Makajio S, Schmidt NC, Vassilakos P, Petignat P. Exploring factors associated with patients who prefer clinician-sampling to HPV self-sampling: a study conducted in a low-resource setting. Int J Environ Res Public Health. 2021;19(1):54. https://doi.org/10.3390/ijerph19010054.CrossRefPubMedPubMedCentral

19.

Cadman L, Reuter C, Jitlal M, Kleeman M, Austin J, Hollingworth T, Parberry AL, Ashdown-Barr L, Patel D, Nedjai B, Lorincz AT, Cuzick J. A randomized comparison of different vaginal self-sampling devices and urine for human papillomavirus testing-predictors 5.1. Cancer Epidemiol Biomarkers Prev. 2021;30(4):661–8. https://doi.org/10.1158/1055-9965.EPI-20-1226.CrossRefPubMedPubMedCentral

20.

Gyllensten U, Sanner K, Gustavsson I, Lindell M, Wikström I, Wilander E. Short-time repeat high-risk HPV testing by self-sampling for screening of cervical cancer. Br J Cancer. 2011;105(5):694–7. https://doi.org/10.1038/bjc.2011.277.CrossRefPubMedPubMedCentral

21.

Bais AG, vanKemenade FJ, Berkhof J, Verheijen RH, Snijders PJ, Voorhorst F, et al. Human papillomavirus testing on self-sampled cervicovaginal brushes: an effective alternative to protect nonresponders in cervical screening programs. Int J Cancer. 2007;120:1505–10.CrossRefPubMed

22.

Gok M, Heideman DA, van Kemenade FJ, et al. HPV testing on self collected cervicovaginal lavage specimens as screening method for women who do not attend cervical screening: cohort study. BMJ. 2010;340:c1040.CrossRefPubMedPubMedCentral

23.

Gok M, van Kemenade FJ, Heideman DA, et al. Experience with high-risk human papillomavirus testing on vaginal brush-based self-samples of non-attendees of the cervical screening program. Int J Cancer. 2012;130:1128–35.CrossRefPubMed

24.

Bosgraaf RP, Mast PP, Struik-van der Zanden PH, Bulten MLF, Bekkers RL. Overtreatment in a see-and-treat approach to cervical intraepithelial lesions. Obstet Gynecol. 2013;121:1209–16.CrossRefPubMed

25.

Sanner K, Wikstrom I, Strand A, Lindell M, Wilander E. Self-sampling of the vaginal fluid at home combined with high-risk HPV testing. Br J Cancer. 2009;101:871–4.CrossRefPubMedPubMedCentral

26.

Smith JS, Des Marais AC, Deal AM, et al. Mailed human papillomavirus self-collection with Papanicolaou test referral for infrequently screened women in the United States. Sex Transm Dis. 2018;45(1):42–8. https://doi.org/10.1097/OLQ.0000000000000681.CrossRefPubMedPubMedCentral

27.

Ernstson A, Urdell A, Forslund O, Borgfeldt C. Cervical cancer prevention among long-term screening non-attendees by vaginal self-collected samples for hr-HPV mRNA detection. Infect Agent Cancer. 2020;15:10. https://doi.org/10.1186/s13027-020-00280-0.CrossRefPubMedPubMedCentral

28.

Huynh J, Howard M, Lytwyn A. Self-collection for vaginal human papillomavirus testing. J Low Genit Tract Dis. 2010;14(4):356–62. https://doi.org/10.1097/lgt.0b013e3181dc115b.CrossRefPubMed

29.

Bosgraaf RP, Verhoef VM, Massuger LF, Siebers AG, Bulten J, de Kuyper-de Ridder GM, et al. Comparative performance of novel self-sampling methods in detecting high-risk human papillomavirus in 30,130 women not attending cervical screening. Int J Cancer. 2015;136(3):646–55.CrossRefPubMed

30.

Nelson EJ, Maynard BR, Loux T, Fatla J, Gordon R, Arnold LD. The ac- ceptability of self-sampled screening for HPV DNA: a systematic review and meta-analysis. Sex Transm Infect. 2017;93(1):56–61.CrossRefPubMed

31.

Peeters E, Benoy I, Vanden Broeck D, Bogers J, De Sutter P, Donders G, Tjalma W, Weyers S, Cuschieri K, Poljak M, Bonde J, Cocuzza C, Zhao FH, Van Keer S, Vorsters A. VALHUDES: a protocol for validation of human papillomavirus assays and collection devices for HPV testing on self-samples and urine samples. J Clin Virol. 2018;107:52–6. https://doi.org/10.1016/j.jcv.2018.08.006.CrossRefPubMed

32.

Avian A, Clemente N, Mauro E, Isidoro E, Di Napoli M, Dudine S, Del Fabro A, Morini S, Perin T, Giudici F, Cammisuli T, Foschi N, Mocenigo M, Montrone M, Modena C, Polenghi M, Puzzi L, Tomaic V, Valenti G, Sola R, Zanolla S, Vogrig E, Riva E, Angeletti S, Ciccozzi M, Castriciano S, Pachetti M, Petti M, Centonze S, Gerin D, Banks L, Marini B, Canzonieri V, Sopracordevole F, Zanconati F, Ippodrino R. Clinical validation of full HR-HPV genotyping HPV Selfy assay according to the international guidelines for HPV test requirements for cervical cancer screening on clinician-collected and self-collected samples. J Transl Med. 2022;20(1):231. https://doi.org/10.1186/s12967-022-03383-x.PMID:35581584;PMCID:PMC9115952.CrossRefPubMedPubMedCentral

33.

Corrigendum to Avian A, Clemente N, Mauro E, Isidoro E, Di Napoli M, Dudine S, Del Fabro A, Morini S, Perin T, Giudici F, Cammisuli T, Foschi N, Mocenigo M, Montrone M, Modena C, Polenghi M, Puzzi L, Tomaic V, Valenti G, Sola R, Zanolla S, Vogrig E, Riva E, Angeletti S, Ciccozzi M, Castriciano S, Pachetti M, Petti M, Centonze S, Gerin D, Banks L, Marini B, Canzonieri V, Sopracordevole F, Zanconati F, Ippodrino R. Correction: clinical validation of full HR-HPV genotyping HPV Selfy assay according to the international guidelines for HPV test requirements for cervical cancer screening on clinician-collected and self-collected samples. J Transl Med. 2023;21(1):49. https://doi.org/10.1186/s12967-023-03882-5. Erratum for: J Transl Med. 2022;20(1):231.

34.

Meijer CJ, Berkhof J, Castle PE, Hesselink AT, Franco EL, Ronco G, Arbyn M, Bosch FX, Cuzick J, Dillner J, Heideman DA, Snijders PJ. Guidelines for human papillomavirus DNA test requirements for primary cervical cancer screening in women 30 years and older. Int J Cancer. 2009;124(3):516–20. https://doi.org/10.1002/ijc.24010.CrossRefPubMedPubMedCentral

35.

Report n.7 from Gruppo Italiano Screening del Cervicocarcinoma (GISCI) “Test validati per lo screening del cervicocarcinoma”. https://gisci.it/documenti/documenti_gisci/Rapporto_N7_Test_HPV_Validati.pdf. Accessed 04 Sept 2022.

36.

https://herqiagen.com/qiascreen/wp-content/uploads/sites/4/2021/10/HB-2579-003_1117669_R2_QIAScreen_PCR_CE_0819_EMEA.pdf. Accessed 04 Sept 2022.

37.

Hesselink AT, Berkhof J, van der Salm ML, van Splunter AP, Geelen TH, van Kemenade FJ, Bleeker MG, Heideman DA. Clinical validation of the HPV-risk assay, a novel real-time PCR assay for detection of high-risk human papillomavirus DNA by targeting the E7 region. J Clin Microbiol. 2014;52(3):890–6. https://doi.org/10.1128/JCM.03195-13.CrossRefPubMedPubMedCentral

38.

Del Mistro A, Frayle H, Ferro A, Fantin G, Altobelli E, Giorgi RP. Efficacy of self-sampling in promoting participation to cervical cancer screening also in subsequent round. Prev Med Rep. 2017;5:166–8. https://doi.org/10.1016/j.pmedr.2016.12.017.CrossRefPubMed

39.

Giorgi Rossi P, Fortunato C, Barbarino P, et al. Self-sampling to increase participation in cervical cancer screening: An RCT comparing home mailing, distribution in pharmacies, and recall letter. Br J Cancer. 2015;112(4):667–75. https://doi.org/10.1038/bjc.2015.11.CrossRefPubMedPubMedCentral

40.

Sultana F, English DR, Simpson JA, et al. Home-based HPV self-sampling improves participation by never-screened and under-screened women: results from a large randomized trial (iPap) in Australia. Int J Cancer. 2016;139(2):281–90. https://doi.org/10.1002/ijc.30031.CrossRefPubMed

41.

Broberg G, Jonasson JM, Ellis J, et al. Increasing participation in cervical cancer screening: telephone contact with long-term non-attendees in Sweden. Results from RACOMIP, a randomized controlled trial. Int J Cancer. 2013;133(1):164–71. https://doi.org/10.1002/ijc.27985.CrossRefPubMed

42.

Vahabi M, Lofters A. HPV self-sampling: a promising approach to reduce cervical cancer screening disparities in Canada. Curr Oncol. 2018;25(1):13–8. https://doi.org/10.3747/co.25.3845.CrossRefPubMedPubMedCentral

43.

Knauss T, Hansen BT, Pedersen K, Aasbø G, Kunst N, Burger EA. The cost-effectiveness of opt-in and send-to-all HPV self-sampling among long-term non-attenders to cervical cancer screening in Norway: the Equalscreen randomized controlled trial. Gynecol Oncol. 2023;168:39–47. https://doi.org/10.1016/j.ygyno.2022.10.027.CrossRefPubMed

44.

Malone C, Barnabas RV, Buist DSM, Tiro JA, Winer RL. Cost-effectiveness studies of HPV self-sampling: a systematic review. Prev Med. 2020;132:105953. https://doi.org/10.1016/j.ypmed.2019.105953.CrossRefPubMedPubMedCentral

45.

Lim AWW. Will COVID-19 be the tipping point for primary HPV self-sampling? Cancer Epidemiol Biomarkers Prev. 2021;30(2):245–7. https://doi.org/10.1158/1055-9965.EPI-20-1538.CrossRefPubMed

46.

Ajenifuja KO, Belinson J, Goldstein A, Desai KT, de Sanjose S, Schiffman M. Designing low-cost, accurate cervical screening strategies that take into account COVID-19: a role for self-sampled HPV typing. Infect Agents Cancer. 2020;15:61. https://doi.org/10.1186/s13027-020-00325-4.CrossRef

47.

Miller MJ, Xu L, Qin J, et al. Impact of COVID-19 on cervical cancer screening rates among women aged 21–65 years in a large integrated health care system—Southern California, January 1–September 30, 2019, and January 1–September 30, 2020. MMWR Morb Mortal Wkly Rep. 2021;70(4):109–13. https://doi.org/10.15585/mmwr.mm7004a1.CrossRefPubMedPubMedCentral

48.

EHRN. Delayed Cancer Screenings. https://ehrn.org/articles/delays-in-preventive-cancer-screenings-during-covid-19-pandemic/. Accessed 04 Sept 2022.

49.

Castanon A, Rebolj M, Burger EA, de Kok IMCM, Smith MA, Hanley SJB, Carozzi FM, Peacock S, O’Mahony JF. Cervical screening during the COVID-19 pandemic: optimising recovery strategies. Lancet Public Health. 2021;6(7):e522–7. https://doi.org/10.1016/S2468-2667(21)00078-5.CrossRefPubMedPubMedCentral

50.

Lozar T, Nagvekar R, Rohrer C, Dube Mandishora RS, Ivanus U, Fitzpatrick MB. Cervical cancer screening postpandemic: self-sampling opportunities to accelerate the elimination of cervical cancer. Int J Womens Health. 2021;13:841–59. https://doi.org/10.2147/IJWH.S288376.CrossRefPubMedPubMedCentral

51.

Arbyn M, Latsuzbaia A, Castle PE, Sahasrabuddhe VV, Broeck DV. HPV testing of self-samples: Influence of collection and sample handling procedures on clinical accuracy to detect cervical precancer. Lancet Reg Health Eur. 2022;14:100332. https://doi.org/10.1016/j.lanepe.2022.100332.CrossRefPubMedPubMedCentral

52.

Ivanus U, Jerman T, Fokter AR, Takac I, Prevodnik VK, Marcec M, Gajsek US, Pakiz M, Koren J, Celik SH, Kramberger KG, Klopcic U, Kavalar R, Zatler SS, Kuzmanov BG, Florjancic M, Nolde N, Novakovic S, Poljak M, Zakelj MP. Randomised trial of HPV self-sampling among non-attenders in the Slovenian cervical screening programme ZORA: comparing three different screening approaches. Radiol Oncol. 2018;52(4):399–412. https://doi.org/10.2478/raon-2018-0036.CrossRefPubMedPubMedCentral

53.

Solomon D, Davey D, Kurman R, Moriarty A, O’Connor D, Prey M, et al. The 2001 Bethesda system terminology for reporting results of cervical cytokogy. JAMA. 2002;287:2114–9.CrossRefPubMed

54.

De Pauw H, Donders G, Weyers S, De Sutter P, Doyen J, Tjalma WAA, Vanden Broeck D, Peeters E, Van Keer S, Vorsters A, Arbyn M. Cervical cancer screening using HPV tests on self-samples: attitudes and preferences of women participating in the VALHUDES study. Arch Public Health. 2021;79:155.CrossRefPubMedPubMedCentral

55.

Hallgren KA. Computing inter-rater reliability for observational data: an overview and tutorial. Tutor Quant Methods Psychol. 2012;8(1):23–34. https://doi.org/10.20982/tqmp.08.1.p023.CrossRefPubMedPubMedCentral

56.

Herzum A, Ciccarese G, Drago F, Pastorino A, Dezzana M, Mavilia MG, Sola S, Copello F, Parodi A. Cervical, oral and anal Human papillomavirus infection in women attending the Dermatology Unit of a regional reference hospital in Genoa, Italy: a prevalence study. J Prev Med Hyg. 2022;63(3):E415–9.PubMedPubMedCentral

57.

Ring LL, Thomsen LT, Haedersdal M, Sørensen SS, Bonde JH, Lok TT, Larsen HK, Kjaer SK. Prevalence of cervical human papillomavirus and the risk of anal co-infection in kidney transplant recipients: results from a Danish clinical study. Transpl Infect Dis. 2023;25(2):e14019.CrossRefPubMed

58.

Ciccarese G, Herzum A, Rebora A, Drago F. Prevalence of genital, oral, and anal HPV infection among STI patients in Italy. J Med Virol. 2017;89(6):1121–4.CrossRefPubMed

59.

https://pim-eservices.roche.com/eLD/api/downloads/3cfba842-99ed-ec11-1791-005056a71a5d?countryIsoCode=it. Accessed 04 Sept 2022.

60.

Bonde J, Ejegod D. Self-sampling to reach non-participating women. 58. 2018. www.HPVWorld.com. https://www.hpvworld.com/media/29/media_section/6/0/960/hpvworld-058.pdf. Accessed 04 Sept 2022.

61.

Daponte N, Valasoulis G, Michail G, Magaliou I, Daponte A-I, Garas A, Grivea I, Bogdanos DP, Daponte A. HPV-based self-sampling in cervical cancer screening: an updated review of the current evidence in the literature. Cancers. 2023;15:1669. https://doi.org/10.3390/cancers15061669.CrossRefPubMedPubMedCentral

62.

Costa S, Verberckmoes B, Castle PE, Arbyn M. Offering HPV self-sampling kits: an updated meta-analysis of the effectiveness of strategies to increase participation in cervical cancer screening. Br J Cancer. 2023;128(5):805–13. https://doi.org/10.1038/s41416-022-02094-w.CrossRefPubMed

63.

Di Gennaro G, Licata F, Trovato A, Bianco A. Does self-sampling for human papilloma virus testing have the potential to increase cervical cancer screening? An updated meta-analysis of observational studies and randomized clinical trials. Front Public Health. 2022;8(10):1003461. https://doi.org/10.3389/fpubh.2022.1003461.PMID:36568753;PMCID:PMC9773849.CrossRef

Title: Evaluation of self-sampling-based cervical cancer screening strategy using HPV Selfy CE-IVD test coupled with home-collection kit: a clinical study in Italy
Authors: Giulia Feltri
Giulio Valenti
Erica Isidoro
Jaspreett Kaur
Marianna Treleani
Aurora Bartelloni
Claudia Mauro
Federica Spiga
Giulia Ticich
Michela Di Napoli
Claudia Biagi
Maria Pachetti
Sandro Centonze
Santina Castriciano
Sara Zanchiello
Fabiola Giudici
Daniela Gerin
Fabrizio Zanconati
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Human Papillomavirus
Cervical Cancer
Cervical Cancer
COVID-19
Published in: European Journal of Medical Research / Issue 1/2023
Electronic ISSN: 2047-783X
DOI: https://doi.org/10.1186/s40001-023-01263-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Evaluation of self-sampling-based cervical cancer screening strategy using HPV Selfy CE-IVD test coupled with home-collection kit: a clinical study in Italy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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