title: Shanxi Province cervical cancer screening study II: self-sampling for high-risk human papillomavirus compared to direct sampling for human papillomavirus and liquid based cervical cytology.
abstract: The objective of this study was to compare the sensitivity and specificity of a new method for self-sampling for high risk human papillomavirus (HPV) with direct sampling and liquid based cervical cytology. In Shanxi Province, China, 8,497 women (ages 27-56) underwent a self-sample for HPV using a conical-shaped brush placed into the upper vagina and rotated. Three to sixteen months later the women were screened with liquid-based cytology and direct HPV tests. Subjects with any abnormal test underwent colposcopy and multiple biopsies. Mean age was 40.9 years. 4.4 percent of subjects had >or=CIN II, 26% a positive self-sample and 24% a positive direct test for HPV. The sensitivity for detection of >or=CIN II was 87.5% for self-sampling, and 96.8% for the direct test (P < 0.001). The specificity was 77.2% for the self-sample and 79.7% for the direct test. With an abnormal Pap defined as ASCUS or greater the sensitivity of the Pap for the detection of >CIN II was 88.3% and the specificity was 81.2%. We conclude that self-sampling for HPV is less sensitive for >CIN II than the direct test, but similar to liquid based cytology.
authors.affiliation: Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. belinsj@ccf.org
authors.forename: J L
authors.initials: JL
authors.lastname: Belinson
authors.forename: Y L
authors.initials: YL
authors.lastname: Qiao
authors.forename: R G
authors.initials: RG
authors.lastname: Pretorius
authors.forename: W H
authors.initials: WH
authors.lastname: Zhang
authors.forename: S D
authors.initials: SD
authors.lastname: Rong
authors.forename: M N
authors.initials: MN
authors.lastname: Huang
authors.forename: F H
authors.initials: FH
authors.lastname: Zhao
authors.forename: L Y
authors.initials: LY
authors.lastname: Wu
authors.forename: S D
authors.initials: SD
authors.lastname: Ren
authors.forename: R D
authors.initials: RD
authors.lastname: Huang
authors.forename: M F
authors.initials: MF
authors.lastname: Washington
authors.forename: Q J
authors.initials: QJ
authors.lastname: Pan
authors.forename: L
authors.initials: L
authors.lastname: Li
authors.forename: D
authors.initials: D
authors.lastname: Fife
mesh_terms: D000328:Adult; D003585:Cell Biology / Q000295:instrumentation; D002584:Cervix Uteri / Q000166:cytology*; D002681:China; D005260:Female; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D027383:Papillomaviridae / Q000472:pathogenicity*; D030361:Papillomavirus Infections / Q000175:diagnosis*; D012307:Risk Factors; D012648:Self Care; D012680:Sensitivity and Specificity; D013048:Specimen Handling; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000821:virology*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000821:virology*