Self-sampling versus physician sampling for cervical cancer screening; The agreement of cytological diagnoses. [Abstract]

Background: The major problem with cervical cancer screening in countries which have no organized national screening program for cervical cancer is sub-optimal participation. Implementation of self-sampling method may increase the participation of women to screen for cervical cancer.
Aims: To determine the agreement of cytological diagnoses made on samples collected by women themselves (self-sampling) versus cytological diagnoses made on samples collected
by physicians (Physician sampling)
Methods: We invited women volunteers to undergo two procedures; cervical self-sampling using the Evalyn brush and physician scraping using Cervex brush. They women were
shown a video presentation on how to take their own cervical samples before the procedure. The samples taken by physicians were taken as per routine testing (Gold Standard). All
samples were subjected to Thin Prep monolayer smears. The diagnoses made were according to the Bethesda classification. The results from the two sampling methods were analysed and compared.
Results: A total of 367 women were recruited into the study. Thin Prep smears by physicians were better in terms of volume and variety of the cells seen. There is significant good agreement of the cytological diagnoses made on the samples from the two sampling methods with the Kappa value of 0.568 (p=0.040). The Thin Prep smears by self-sampling method were better in detecting microorganisms.
Conclusion: This study shows that samples taken by women themselves (self-sampling) and physicians sampling had good cytology agreement. Self-sampling could be the method of
choice in countries in which the coverage of women attending clinics for screening for cervical cancer is poor.