Diagnostic accuracy of self-collected human papillomavirus specimens as a primary screen for cervical cancer.
The aim of the study was to compare the sensitivity of self-collected with clinician-collected human papillomavirus (HPV) tests and cytology for cervical cancer. A total of 250 non-pregnant, 25-60-year-old women from Leon, Nicaragua, self-collected vaginal specimens for HPV and received a pelvic examination for cytology and reflex HPV. All participants underwent colposcopy and completed questionnaires regarding demographic and medical information. The sensitivities of self-collected brushes, self-collected swabs and clinician-collected HPV tests were 25%, 16.7%, and 16.7%, respectively, with colposcopy as the gold standard and 30%, 22.2% and 40% when cytology was the gold standard. Agreement between self-collection methods was significant (κ=0.84, p<0.001). Although utilisation of colposcopy in every participant resulted in lower sensitivities, the self-collected tests surpassed cytology and significantly agreed with the clinician-collected results. Further clarification of the sensitivity will be required to employ self-collection for cervical cancer screening in low resource areas like rural Nicaragua.
Department of Physician Assistant Studies, Elon University, Elon, NC 27244, USA. bquincy@elon.edu
B L
BL
Quincy
D J
DJ
Turbow
L N
LN
Dabinett
R
R
Dillingham
S
S
Monroe
D000328:Adult; D003127:Colposcopy; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D009527:Nicaragua; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis*; D012648:Self Care; D012680:Sensitivity and Specificity; D013048:Specimen Handling; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014621:Vagina / Q000821:virology*