title: Self-collection for high-risk HPV detection in Brazilian women using the careHPV™ test.
abstract: OBJECTIVE
  Cervical cancer is the second most common cancer among Brazilian women. High-risk human papillomavirus (hr-HPV) persistence is the primary cause of cervical neoplasia. Early detection of hr-HPV is important for identifying women at risk for developing cervical lesions. Approximately 85% of new cases of cervical cancer worldwide and 50% of the total cervical cancer deaths occurred in developing countries. Here, a new methodology to support a cervical cancer screening program was evaluated in women from various Brazilian regions.
  
  
  METHODS
  Two thousand women aged 18-77 years were enrolled in an opportunistic cervical cancer screening program and were randomized into self-vaginal or health professional-guided cervical sampling groups. The Qiagen careHPV™ test was performed on all samples. Pap tests were performed on all women using liquid-based cytology.
  
  
  RESULTS
  Positive hr-HPV results were obtained in 12.3% (245/2000) of women; similar rates were observed in self- or health professional-collected samples. Eighty-nine percent (1719/2000) of cervical cytologies classified as normal were negative to hr-HPV. Among the cytological samples, 36.6% classified as ASC-US+ were positive to hr-HPV, 78.8% were LSIL and 75.0% were HSIL.
  
  
  CONCLUSIONS
  Self-sampled and health professional-sampled vaginal/cervical specimens did not differ in their rates of detection of hr-HPV. Therefore, HPV DNA testing in self-sampled vaginal cells is an alternative to primary screening in low-resource settings.
authors.affiliation: Molecular Oncology Center, Barretos Cancer Hospital, Barretos, São Paulo, Brazil. Electronic address: adriana.lorenzi@gmail.com.
authors.forename: Adriana Tarlá
authors.initials: AT
authors.lastname: Lorenzi
authors.forename: José Humberto T G
authors.initials: JH
authors.lastname: Fregnani
authors.forename: Júlio César
authors.initials: JC
authors.lastname: Possati-Resende
authors.forename: Cristovam Scapulatempo
authors.initials: CS
authors.lastname: Neto
authors.forename: Luisa Lina
authors.initials: LL
authors.lastname: Villa
authors.forename: Adhemar
authors.initials: A
authors.lastname: Longatto-Filho
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000175:diagnosis*; D011933:Reagent Kits, Diagnostic; D012648:Self Care; D013048:Specimen Handling; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000821:virology; D014626:Vaginal Smears; D055815:Young Adult
chemical_list: D011933:Reagent Kits, Diagnostic
keywords: Cervical cancer; Human papillomavirus; Molecular test; Screening; Self-sampling