title: Can self vaginal douching for high risk HPV screening replace or assist efficacy of cervical cancer screening?
abstract: OBJECTIVE
  To study the accuracy of self vaginal douching and collection for HPV types 16, 18, 31 and 33 in women visiting Thammasat Hospital for the explicit purpose of cervical screening.
  
  
  METHODS
  A pelvic examination and Pap smear were performed for all women who came for cervical screening. Specimens were also collected by self vaginal douching before cervical screening and sent to the cell and molecular biology laboratory for analysis of human papillomavirus (HPV) types 16, 18, 31 and 33 using the polymerase chain reaction (PCR).
  
  
  RESULTS
  HPV prevalence was 3.6% overall from 250 women in this study. Twenty-four (9.6%) women had an abnormal cytology screening result. No cancer was found. Four women had a high grade squamous intraepithelial lesion (HSIL) and 14 had a low grade squamous intraepithelial lesion (LSIL) from colposcopic biopsy. Self vaginal douching for HPV 16, 18, 31 and 33 was used to predict abnormal Pap smear. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 12.5%, 97.5%, 33.3% and 91.3%, respectively.
  
  
  CONCLUSIONS
  From our analysis of self-vaginal douching for HPV detection using cases from Thammasat university hospital, it cannot replace the Pap smear.
authors.affiliation: Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand. k_suwannarurk@yahoo.com
authors.forename: Komsun
authors.initials: K
authors.lastname: Suwannarurk
authors.forename: Kornkarn
authors.initials: K
authors.lastname: Bhamarapravatana
authors.forename: Pakpoom
authors.initials: P
authors.lastname: Kheolamai
authors.forename: Yuttadej
authors.initials: Y
authors.lastname: Thaweekul
authors.forename: Karicha
authors.initials: K
authors.lastname: Mairaing
authors.forename: Yenrudee
authors.initials: Y
authors.lastname: Poomtavorn
authors.forename: Junya
authors.initials: J
authors.lastname: Pattaraarchachai
mesh_terms: D000328:Adult; D004279:DNA, Viral / Q000032:analysis; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D058869:Gynecological Examination / Q000379:methods; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D016133:Polymerase Chain Reaction; D013048:Specimen Handling; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000517:prevention & control / Q000821:virology; D044364:Vaginal Douching / Q000379:methods*; D014626:Vaginal Smears
chemical_list: D004279:DNA, Viral