title: Cervicovaginal self-sampling is a reliable method for determination of prevalence of human papillomavirus genotypes in women aged 20 to 30 years.
abstract: Self-sampling by cervicovaginal lavage could be an attractive method to detect high-risk human papillomavirus (hr-HPV) infections to identify women with a risk of cervical precancer. The objective of our study was to use self-sampling for the first time in a cross-sectional approach to determine HPV prevalence and genotype distribution. We evaluated participants' acceptance and laboratory results from self-obtained samples versus endocervical brush samples obtained by gynecologists. To determine the sensitivity of both sampling methods in presumed high- and low-prevalence settings, two groups of women 20 to 30 years of age with (n = 55) and without (n = 101) a recent suspicious cytological smear were compared. Overall, 76% (95% confidence interval [95% CI], 65 to 88) of women with and 40% (95% CI, 30 to 49) of women without a recent suspicious cytological smear tested HPV positive. The prevalences of high-risk HPV strains were 71% (95% CI, 59 to 83) and 32% (95% CI, 22 to 41), respectively, for these two groups. The agreement for hr-HPV between the two sampling methods for women with and without suspicious cytology was 84% (κ = 0.65; 95% CI, 0.44 to 0.86) and 91% (κ = 0.78; 95% CI, 0.64 to 0.92), respectively. Participants rated the user-friendliness of the self-sampling method on a visual analog scale from 0 (easy) to 100 (difficult) with a median of 12. In conclusion, self-sampling by cervicovaginal lavage is a reliable method to determine hr-HPV prevalence and is well accepted by young adult females.
authors.affiliation: Immunization Unit, Department for Infectious Disease Epidemiology, Robert Koch Institute, DGZ-Ring 1, 13086 Berlin, Germany. delerey@rki.de
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Deleré
authors.forename: Melanie
authors.initials: M
authors.lastname: Schuster
authors.forename: Elena
authors.initials: E
authors.lastname: Vartazarowa
authors.forename: Thomas
authors.initials: T
authors.lastname: Hänsel
authors.forename: Ingke
authors.initials: I
authors.lastname: Hagemann
authors.forename: Simone
authors.initials: S
authors.lastname: Borchardt
authors.forename: Heike
authors.initials: H
authors.lastname: Perlitz
authors.forename: Achim
authors.initials: A
authors.lastname: Schneider
authors.forename: Sabine
authors.initials: S
authors.lastname: Reiter
authors.forename: Andreas M
authors.initials: AM
authors.lastname: Kaufmann
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000821:virology; D003430:Cross-Sectional Studies; D005260:Female; D005838:Genotype; D006801:Humans; D027383:Papillomaviridae / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000821:virology; D015995:Prevalence; D016353:Self-Examination / Q000379:methods*; D012680:Sensitivity and Specificity; D013048:Specimen Handling / Q000379:methods*; D014621:Vagina / Q000821:virology; D044364:Vaginal Douching / Q000379:methods