title: Vaginal self sampling versus physician cervical sampling for HPV among younger and older women.
abstract: OBJECTIVE
  To estimate the agreement between self collected vaginal swabs and physician collected cervical brush samples for detection of oncogenic human papillomavirus infection (HPV) by the hybrid capture 2 (HC-2) test among women younger and older than 50 years, and to assess women's preference for sample collection method based on age.
  
  
  METHODS
  Consecutive women aged 15-49 years due for a 1 year visit in a prevalence study of carcinogenic HPV and a new sample of women aged 50 years and older attending their family physicians for cervical screening, in Ontario, Canada, performed vaginal self sampling and underwent physician cervical sampling and cervical cytology. Women completed a self administered questionnaire on demographics and preference for sampling method.
  
  
  RESULTS
  Among the 307 women aged 15-49 years, the prevalence of HPV was 20.8% (64/307) and 17.6% (54/307) in the vaginal and cervical specimens, respectively. Among the women aged 50 years and older, prevalence was 9.9% (15/152) and 8.6% (13/152), respectively. Kappa for agreement between sample collection methods was 0.54 for the younger and 0.37 for the older women (both p< 0.001). Nearly half of the women preferred self sampling or had no preference.
  
  
  CONCLUSIONS
  There was fair agreement between self collected vaginal and physician collected cervical specimens for detecting carcinogenic HPV in younger and older women. Vaginal sampling for HPV appears to be promising as a primary screening strategy for cervical cancer prevention programmes in low resource settings in developed and developing countries.
authors.affiliation: Department of Family Medicine, McMaster University, 75 Frid Street, Hamilton, Ontario, Canada L8P 4M3. karwalt@mcmaster.ca
authors.forename: T
authors.initials: T
authors.lastname: Karwalajtys
authors.forename: M
authors.initials: M
authors.lastname: Howard
authors.forename: J W
authors.initials: JW
authors.lastname: Sellors
authors.forename: J
authors.initials: J
authors.lastname: Kaczorowski
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000523:psychology; D017060:Patient Satisfaction; D014626:Vaginal Smears / Q000379:methods* / Q000523:psychology