title: Vaginal self-sampling is an adequate means of screening HR-HPV types in women not participating in regular cervical cancer screening.
abstract: In France, about 40% of women aged 25-65 years do not participate in regular screening and thus are at high risk (HR) of cervical cancer. Human papillomavirus (HPV) vaginal self-sampling is a valuable alternative in this population. This study aimed to assess the prevalence of HR and LR (low-risk) HPV infection in 3767 women aged >35 years from mid-socioeconomic backgrounds who carried out HPV vaginal self-sampling at home. HPV vaginal self-sampling was better accepted than the Pap-test in women aged 35-69 years who were previously non-responders to individual invitation. From the 933 self-collected swabs studied (24.7%), 62 were HPV-infected (6.6%), and 73 HPV types were found. HPV 16 was the most frequently found (43.5%), followed by 53 (23.2%), 18 (12.3%), 66 (12.3%), 31 (6.8%), 33 (5.4%) and 58 (2.7%). Ten women (16.2%) were infected by multiple HR-HPV types. Median HPV 16 load was 104.000 copies/10(6) cells and median HPV 18 load was 833 copies/10(6) cells. Six women (9.3%) harboured LR-HPV types. The 12-month follow-up of 43 HR-HPV positive women (69.3%) revealed CIN2-3 lesions in three women (6.9%), all HPV 16 infected, and harbouring an HPV 16 load >5 log(10) copies/10(6) cells. Women harbouring HR-HPV types other than HPV 16/18 were older than women harbouring HPV 16/18 types (55 years vs. 46.9 years, p 0.0008). The high frequency of HR-HPV types in women >50 years deserves further investigation to elucidate the mechanism involved (re-infection or reactivation).
authors.affiliation: Fédération de Microbiologie Clinique, CNRS UMR 7278 IRD, CHU La Timone, Marseille Cedex 05. Electronic address: catherine.tamalet@ap-hm.fr.
authors.forename: C
authors.initials: C
authors.lastname: Tamalet
authors.affiliation: Association pour la recherche et le dépistage des cancers du sein, du col de l'utérus et des cancers colorectaux (Arcades), Marseille Cedex 10.
authors.forename: L
authors.initials: L
authors.lastname: Le Retraite
authors.affiliation: Association pour la recherche et le dépistage des cancers du sein, du col de l'utérus et des cancers colorectaux (Arcades), Marseille Cedex 10.
authors.forename: F-X
authors.initials: FX
authors.lastname: Leandri
authors.affiliation: Association pour la recherche et le dépistage des cancers du sein, du col de l'utérus et des cancers colorectaux (Arcades), Marseille Cedex 10.
authors.forename: P
authors.initials: P
authors.lastname: Heid
authors.affiliation: Epidaure, CRLC Val-d'Aurelle, Montpellier Cedex 10, France.
authors.forename: H Sancho
authors.initials: HS
authors.lastname: Garnier
authors.affiliation: Association pour la recherche et le dépistage des cancers du sein, du col de l'utérus et des cancers colorectaux (Arcades), Marseille Cedex 10.
authors.forename: L
authors.initials: L
authors.lastname: Piana
mesh_terms: D000328:Adult; D000368:Aged; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D005602:France / Q000453:epidemiology; D052162:Human papillomavirus 16 / Q000302:isolation & purification; D052161:Human papillomavirus 18 / Q000302:isolation & purification; D006801:Humans; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000821:virology*; D010358:Patient Participation / Q000706:statistics & numerical data; D015995:Prevalence; D018570:Risk Assessment; D013048:Specimen Handling / Q000379:methods* / Q000706:statistics & numerical data; D014626:Vaginal Smears / Q000379:methods* / Q000706:statistics & numerical data