title: Human papillomavirus detection in self-collected vaginal specimens and matched clinician-collected cervical specimens.
abstract: Human papillomavirus (HPV) detection is an integral part of cervical cancer screening, and a range of specimen collection procedures are being tested. Preliminary studies have found that the majority of women prefer self-collection of vaginal specimens instead of clinician-collected specimens of the cervix. The purposes of the current study were to explore the social and behavioral predictors of acceptance of self-collection of vaginal specimens among patients and to assess concordance in detection of HPV between clinician-collected cervical specimens and self-collected vaginal specimens. The study was conducted at a university family medicine clinic using a cross-sectional study design, and enrollment of women presenting for routine gynecological examination consecutively in a period of 1 year, self-administered questionnaires, collection of paired vaginal and cervical specimens for HPV DNA using Hybrid Capture 2, and cytologic analysis. Most women (79.8% [398/499]) agreed to collect vaginal specimens. In our study, 76.6% (216/282) African American women (AA), 88.1% (156/176) white non-Hispanic (WNH) women, and 63.4% (26/41) women of other races (P < 0.0001) agreed to self-collect vaginal specimens. HPV was detected in 16.0% (80/499) of clinician-collected cervical specimens and 26.1% (104/398) of self-collected vaginal specimens (P < 0.001). HPV detection was concordant in 13.4% (53/398) women in both cervical and vaginal specimens. Self-collection of vaginal specimens for HPV DNA detection is acceptable to most women presenting for routine gynecological examination. WNH women were more likely to obtain self-collected specimens than AA women. Vaginal specimens were more likely to be positive for HPV than were cervical specimens.
authors.affiliation: Department of Family Medicine, School of Medicine, and Greenebaum Cancer Center, University of Maryland, Baltimore, Maryland, USA. nkhanna@som.umaryland.edu
authors.forename: N
authors.initials: N
authors.lastname: Khanna
authors.forename: S I
authors.initials: SI
authors.lastname: Mishra
authors.forename: G
authors.initials: G
authors.lastname: Tian
authors.forename: M T
authors.initials: MT
authors.lastname: Tan
authors.forename: S
authors.initials: S
authors.lastname: Arnold
authors.forename: C
authors.initials: C
authors.lastname: Lee
authors.forename: S
authors.initials: S
authors.lastname: Ramachandran
authors.forename: L
authors.initials: L
authors.lastname: Bell
authors.forename: C R
authors.initials: CR
authors.lastname: Baquet
authors.forename: A
authors.initials: A
authors.lastname: Lorincz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D052685:Alphapapillomavirus / Q000235:genetics / Q000302:isolation & purification*; D002584:Cervix Uteri / Q000473:pathology / Q000821:virology*; D015344:DNA Probes, HPV / Q000032:analysis; D005260:Female; D006801:Humans; D016555:Matched-Pair Analysis; D008875:Middle Aged; D008954:Models, Biological; D010342:Patient Acceptance of Health Care; D013048:Specimen Handling / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000821:virology*; D014626:Vaginal Smears / Q000379:methods*; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000821:virology*
chemical_list: D015344:DNA Probes, HPV