title: Dry self-sampling versus provider-sampling of cervicovaginal specimens for human papillomavirus detection in the Inuit population of Nunavik, Quebec.
abstract: OBJECTIVE
  To assess the comparability of self-collected cervicovaginal samples and provider-collected cervical samples for the detection of human papillomavirus (HPV) DNA among Inuit women in Nunavik, Quebec, avoiding the use of liquid-based storage and transport of the self-collected samples.
  
  
  METHODS
  Ninety-three women aged 18-69 years were recruited from a previously formed cohort on the natural history of HPV to this cross-sectional measurement study. This study utilized HPV DNA test results from 89 paired specimens collected by study participant and health provider with Dacron swabs. Samples were tested for 36 HPV types with the PGMY-primer PCR protocol and genotyping with the linear array method. Unweighted kappa statistics and McNemar tests were used to measure the agreement between sampling techniques.
  
  
  RESULTS
  In the self-collected samples, 30 different HPV types were found, compared with 29 types found in the provider-collected samples. The prevalence of high-risk (HR) HPV was 38.2% in the self-collected samples and 28.1% in the provider-collected samples. The agreement between collection methods for the detection of HR-HPV DNA (85.4%) was good. HR-HPV and type-specific HPV 16/18 were as likely to be detected in the self-collected samples compared with the provider-obtained samples.
  
  
  CONCLUSIONS
  Women in this population were easily able to collect adequate cervicovaginal specimens for HPV testing. As self-sampling has a high recovery of HR-HPV and is comparable with provider-sampling, we conclude that self-sampling with dry storage and transport could be a good cervical cancer screening alternative for Inuit women in Nunavik who have traditionally avoided speculum examination.
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada.
authors.forename: Helen
authors.initials: H
authors.lastname: Cerigo
authors.forename: François
authors.initials: F
authors.lastname: Coutlée
authors.forename: Eduardo L
authors.initials: EL
authors.lastname: Franco
authors.forename: Paul
authors.initials: P
authors.lastname: Brassard
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002584:Cervix Uteri / Q000473:pathology / Q000821:virology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003890:Desiccation; D059026:Diagnostic Self Evaluation; D055088:Early Detection of Cancer / Q000379:methods / Q000523:psychology; D005260:Female; D006282:Health Personnel; D006801:Humans; D004930:Inuit / Q000523:psychology / Q000706:statistics & numerical data; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis* / Q000208:ethnology / Q000523:psychology; D011153:Population; D011792:Quebec / Q000453:epidemiology; D013048:Specimen Handling / Q000379:methods; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000209:etiology / Q000473:pathology; D014626:Vaginal Smears / Q000379:methods*; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000208:ethnology / Q000209:etiology / Q000473:pathology