Effects of Nakhon Pathom Hospital HPV Screening Model on Access to Services and Incidence of HPV Infection Via HPV DNA Test
Keywords:
Cervical Neoplasms, HPV DNA Tests, Self-Sampling, Health Services Accessibility, HPV IncidenceAbstract
Purpose: This study aimed to examine (1) knowledge of cervical cancer, (2) awareness of cervical cancer screening, (3) satisfaction with services, (4) accessibility to cervical cancer screening, and (5) incidence of HPV infection among experimental and control groups before and after implementing the “Nakhon Pathom Hospital HPV Screening Model (NPH-HPV Model)”.
Design: A quasi-experimental study with a two-group pretest–posttest design was employed.
Methods : The study was conducted in Nakhon Pathom Province between June and August 2025. The primary sample consisted of 72 women (36 in the intervention group and 36 in the control group) selected through systematic random sampling. In addition, data on service access and HPV infection were collected from 933 women who underwent screening during the three-month study period. Data were analyzed using descriptive statistics, t-tests, Chi-square tests, Fisher's exact test, ANCOVA, and relative risk.
Results: After the intervention, the intervention group showed a statistically significant increase in knowledge of cervical cancer as well as awareness of cervical cancer screening (p<.001). They also reported a high level of satisfaction with the service model. The rate of access to screening services was significantly 3.09 times higher in the intervention group compared to the control group (p<.001), demonstrating a significant increase in access among vulnerable populations. The overall incidence of HPV infection was 13.72 %, with no statistically significant difference observed between the groups (p=.096).
Conclusion and recommendations: The NPH-HPV Model is demonstrably effective and suitable for implementation as both a primary and secondary prevention strategy. It is recommended for scale-up to enhance community-level access to health services, aligning with World Health Organization (WHO) guidelines, and be adopted for nationwide expansion to effectively reduce the gap in screening service access across the country.
References
กรมวิทยาศาสตร์การแพทย์. (2566). รายงานสถานการณ์โรคมะเร็งปากมดลูกในประเทศไทย. กระทรวงสาธารณสุข.
กรมวิทยาศาสตร์การแพทย์. (2567). แนวทางการตรวจคัดกรองมะเร็งปากมดลูดด้วยวิธี HPV DNA Test. [เอกสารอิเล็กทรอนิกส์]. https://www.dmsc.moph.go.th/th/detailAll/236/nw/25
กระทรวงสาธารณสุข. (2567). ข้อมูลคลังสุขภาพด้านการแพทย์และสุขภาพจังหวัดนครปฐม.[ข้อมูลออนไลน์]. https://hdc.moph.go.th/npt/public/kpi/1/2024
จันทร์ทิมา สุดสมบูรณ์, สุมลรัตน์ ขนอม, และ ฉัตรสุดา กานกายันต์. (2567). ปัจจัยที่มีความสัมพันธ์กับการเข้ารับการตรวจคัดกรองมะเร็งปากมดลูกของสตรีไทย. วารสารวิจัยทางวิทยาศาสตร์สุขภาพ, 18(1), 45–58.
บงกชจันทร์ กถนานนท์, วรนุช เกลี้ยงพิบูลย์, และวันเพ็ญ วิศิษฏ์ชัยนนท์. (2563). การพัฒนาสื่อภาพพลิกเพื่อส่งเสริมการตรวจคัดกรองมะเร็งปากมดลูก. วารสารการส่งเสริมสุขภาพและอนามัยสิ่งแวดล้อม, 43(3), 112–123.
สุวิมล สอนศรี, วาริณี เอี่ยมสวัสดิกุล, และชื่นจิตร โพธิศัพท์สุข. (2564). ผลของโปรแกรมส่งเสริมการตรวจคัดกรองมะเร็งปากมดลูกสตรีกลุ่มเสี่ยง อำเภอเสลภูมิ จังหวัดร้อยเอ็ด. วารสารพยาบาล, 70(3), 11–19.
สำนักงานสาธารณสุขจังหวัดนครปฐม. (2567). รายงานผลการดำเนินงานตรวจคัดกรองมะเร็งปากมดลูกจังหวัดนครปฐม ปี 2565–2567. กลุ่มงานควบคุมโรคไม่ติดต่อ สำนักงานสาธารณสุขจังหวัดนครปฐม.
Arbyn, M., Simon, M., Peeters, E., Xu, L., Meijer, C. J. L. M., & Berkhof, J. (2022). Detecting cervical precancer and reaching under screened women by using HPV testing on self samples: Updated meta-analyses. BMJ, 376, e0060929.
Arrossi, S., Thoumi, V., Carballo, M., Artaza, A., Agüero, F., & Sanca, V. (2021). Self-sampling for HPV testing in cervical cancer screening programs in low- and middle-income countries: A systematic review. The Lancet Global Health, 9(8), e1102–e1112.
Becker, M. H., & Maiman, L. A. (1975). The Health Belief Model: Origins and correlates in psychological theory. Health ducation Quarterly, 2(4), 409–419. Cohen, J. (1997). Statistical power analysis for the behavioral sciences (2nd ed.). Routledge.
Costa, S., Venturoli, S., Origoni, M., Sideri, M., & Sandri, M. T. (2022). Self-sampling for HPV DNA detection: A meta-analysis on accuracy, compliance and acceptability. Cancers, 14(5), 1247. https://doi.org/10.3390/cancers14051247
DeVellis, R. F. (2016). Scale evelopment: Theory and applications (4th ed.). SAGE Publications.
Faul, F., Erdfelder, E., Lang, A.-G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior research Methods, 39(2), 175–191. https://doi.org/10.3758/BF03193146
Kuder, G. F., & Richardson, M. W. (1937). The theory of the estimation of test reliability. Psychometrika, 2(3), 151–160. https://doi.org/10.1007/BF02288391
Nelson, E. J., Maynard, B. R., Loux, T. M., Fatla, J., Gordon, R., & Arnold, L. D. (2021). The acceptability of self-sampled screening for HPV DNA: A systematic review and meta-analysis. Sexually Transmitted Infections, 97(2), 104–111. https://doi.org/10.1136/ extrans-2020-054468
Ploysawang, P., Pitakkarnkul, S., Kolaka, W., Rattanasrithong, P., Khomphiboonkij, U., Tipmed, C., Suksri, P., Thongngam, P., Sritipsukho, S., Chumsri, S., & Sangrajrang, S. (2023). Acceptability and preference for human papillomavirus self-sampling among Thai women attending National Cancer Institute. Asian Pacific Journal of Cancer Prevention: APJCP, 24(2), 607.
Rosenstock, I. M. (1974). Historical origins of the Health Belief Model. Health Education Monographs, 2(4), 328–335.
Sung, H., Ferlay, J., Siegel, R. L., Laversanne, I., Soerjomataram, I., Jemal, A., & Bray, F. (2021). Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, 71(3), 209–249. https://doi.org/10.3322/caac.21660
Wang, Y., Li, Z., Sun, Y., Wang, W., Xu, S., Li, H., & Chen, W. (2020). Clinical effectiveness of self-sampling for HPV DNA testing compared with physician-collected samples: A randomized controlled trial. Cancer Epidemiology, Biomarkers & Prevention, 29(1), 05–111.
World Health Organization. (2020). Global strategy to accelerate the elimination of cervical cancer as a public health problem. WHO. https://www.who.int/publications/i/item/9789240014107
Xue, S., Zeng, X., Li, J., Kang, L., Xi, M., Xu, L., Fu, P., Zhou, M., Ao, M., Yao, X., Li, D., & Liao, G. (2025). Feasibility and acceptability of human papillomavirus self-sampling compared with clinician sampling in urban areas of western China: A cross-sectional survey. Frontiers in Public Health, 13, 24796.Yamane, T. (1967). Statistics: An introductory analysis (2nd ed.). Harper and Row.
Zeferino, L. C., & Derchain, S. F. M. (2018). Cervical cancer in the developing world. Best Practice & Research Clinical Obstetrics & Gynaecology, 47, 3–12. https://doi.org/10.1016/j.bpobgyn.2017.08.006
