Self-sampling for human papillomavirus in a community setting: feasibility in Hispanic women.
BACKGROUND
The aim of the study was (a) to assess sensitivity and specificity of self-sampling in a community setting for identifying high-risk human papillomavirus (HPV) infection and abnormal Papanicolaou (Pap) smears and (b) to assess satisfaction with this collection method among Hispanic women.


METHODS
Lay health workers distributed self-collection kits to Hispanic women in the community. Participants collected an unsupervised vaginal sample at home or in the place and time of their preference.


RESULTS
A total of 1,213 Hispanics were included and provided a self-sample for HPV testing and were invited for a Pap smear; 662 (55%) of them had a Pap smear and the first 386 of these also had a physician-collected sample for HPV retesting. Using physician collection as the gold standard, unsupervised self-collection had a sensitivity of 90% and specificity of 88% for identifying high-risk HPV. Compared with physician sampling, self-sampling in a community setting had comparable sensitivity for identifying a low-grade lesions or greater in the Pap smear (50% versus 55%; P = 0.45) but lower specificity (94% versus 79%). Overall experience with self-sampling was reported as excellent or very good by 64% and only 2.6% reported a poor or fair experience.


CONCLUSIONS
Unsupervised self-collection of vaginal samples for HPV testing in a community setting has a high sensitivity for identifying high-risk HPV and a high satisfaction among Hispanics. This approach may benefit populations with limited access to health care or with cultural barriers to cervical cancer screening.
De Alba
Israel
I
Department of Medicine, School of Medicine, University of California-Irvine, Irvine, California, USA. idealba@uci.edu
Anton-Culver
Hoda
H
Hubbell
F Allan
FA
Ziogas
Argyrios
A
Hess
James R
JR
Bracho
America
A
Arias
Caleb
C
Manetta
Alberto
A
D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D005240:Feasibility Studies; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000473:pathology; D012648:Self Care; D012680:Sensitivity and Specificity; D014626:Vaginal Smears / Q000379:methods*