title: Human papillomavirus infection in women in Puerto Rico: agreement between physician-collected and self-collected anogenital specimens.
abstract: OBJECTIVE
  This study aimed to describe the prevalence and concordance between cervical and anal human papillomavirus (HPV) infection and compare cervicovaginal and anal self-collection methods for HPV testing between physician and self-collected specimens in women in Puerto Rico.
  
  
  METHODS
  Specimens for HPV-DNA testing were obtained from 100 women aged 18 to 34 years attending a general gynecology clinic for a routine Pap smear. Human papillomavirus testing was performed using polymerase chain reaction MY09/MY11 primers. Positive samples were typed for 39 genotypes. Agreement between sampling methods was determined by percent agreement and the κ statistic.
  
  
  RESULTS
  For the 39 genotypes evaluated, 38.4% (38/99) of cervicovaginal and 33.7% (30/89) of anal physician-collected samples were HPV+, whereas 35.1% (34/97) of cervicovaginal and 32.0% (31/97) of anal self-collected samples were positive. Human papillomavirus type 16 was the most common type identified in the cervix (8.3%, 8/97) and the anus (5.6%, 5/89) of physician-collected samples, with similar prevalence in self-collected samples. Concordance between cervical and anal HPV infection was high (>90%) for all types evaluated. There was a strong percent agreement between physician- and self-collected cervicovaginal and anal samples (>95% for all HPV types) and good to excellent agreement (κ > 0.60) for most HPV types.
  
  
  CONCLUSIONS
  The clinic-based prevalence of anal and cervicovaginal HPV infection was high, with a strong concordance between cervical and anal infection and good to excellent agreement between physician- and self-collected samples. This study supports the feasibility of using cervical and anal self-sampling methods in future population-based studies of HPV infection in Puerto Rico and as an HPV screening method in women.
authors: Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center and Biostatistics and Epidemiology Department, Graduate School of Public Health, University of Puerto Rico, PMB 711, Ave de Diego89, Suite 105, San Juan, PR 00927-6346. ana.ortiz7@upr.edu
authors: Ana Patricia
authors: AP
authors: Ortiz
authors: Josefina
authors: J
authors: Romaguera
authors: Cynthia M
authors: CM
authors: Pérez
authors: Yomayra
authors: Y
authors: Otero
authors: Marievelisse
authors: M
authors: Soto-Salgado
authors: Keimari
authors: K
authors: Méndez
authors: Yari
authors: Y
authors: Valle
authors: Maria
authors: M
authors: Da Costa
authors: Erick
authors: E
authors: Suarez
authors: Joel
authors: J
authors: Palefsky
authors: Guillermo
authors: G
authors: Tortolero-Luna
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000379:methods*; D001004:Anus Diseases / Q000175:diagnosis / Q000453:epidemiology; D004279:DNA, Viral / Q000235:genetics / Q000302:isolation & purification; D005260:Female; D005838:Genotype; D006801:Humans; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D011647:Puerto Rico / Q000453:epidemiology; D012646:Self Administration / Q000379:methods*; D013048:Specimen Handling / Q000379:methods*; D002577:Uterine Cervical Diseases / Q000175:diagnosis / Q000453:epidemiology; D055815:Young Adult
chemical_list: D004279:DNA, Viral