title: Agreement between self- and clinician-collected specimen results for detection and typing of high-risk human papillomavirus in specimens from women in Gugulethu, South Africa.
abstract: We assessed the agreement in detection of high-risk human papillomavirus (HPV), as well as specific HPV types, between self- and clinician-obtained specimens for 450 women over 18 years of age attending a community health center in Gugulethu, South Africa. Both self-collected swabs and tampons had high agreement with clinician-obtained brushes when the Roche Reverse Line Blot Assay (RLBA) was used (for swabs, 86% concordance, with a kappa statistic [kappa] of 0.71; for tampons, 89% concordance, with kappa of 0.75). Agreement was lower, although still fair, with the Digene Hybrid Capture 2 test (HC2), with kappa higher for swabs than for tampons (for swabs, 81% concordance, with kappa of 0.61; for tampons, 82% concordance, with kappa of 0.55). Low-risk HPV types were nearly two times more common in self-collected specimens than in clinician-collected specimens tested by RLBA. All 15 women diagnosed with high-grade lesions by cytology tested positive for high-risk HPV with clinician-collected specimens tested by RLBA and HC2, while 11 out of 15 tested positive with self-collected specimens by HC2 and 5 out of 6 tested positive by RLBA. Self-collected specimens can provide valid specimens for HPV testing using nucleic acid amplification tests, although a few cytological abnormalities may be missed.
authors.affiliation: Population Council, New York, New York 10017, USA.
authors.forename: Heidi E
authors.initials: HE
authors.lastname: Jones
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Allan
authors.forename: Janneke H H M
authors.initials: JH
authors.lastname: van de Wijgert
authors.forename: Lydia
authors.initials: L
authors.lastname: Altini
authors.forename: Sylvia M
authors.initials: SM
authors.lastname: Taylor
authors.forename: Alana
authors.initials: A
authors.lastname: de Kock
authors.forename: Nicol
authors.initials: N
authors.lastname: Coetzee
authors.forename: Anna-Lise
authors.initials: AL
authors.lastname: Williamson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D052576:Menstrual Hygiene Products; D008875:Middle Aged; D021141:Nucleic Acid Amplification Techniques / Q000379:methods; D027383:Papillomaviridae / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000821:virology; D015203:Reproducibility of Results; D012307:Risk Factors; D012648:Self Care; D012680:Sensitivity and Specificity; D013019:South Africa / Q000453:epidemiology; D013048:Specimen Handling / Q000379:methods*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000821:virology
chemical_list: D004279:DNA, Viral