title: Evaluation of genital self-sampling methods for HPV detection in males.
abstract: BACKGROUND
  There are no population-based HPV prevalence estimates in males because optimal sampling methods are unclear.
  
  
  OBJECTIVE
  To evaluate the acceptability, feasibility, and validity of different male genital self-sampling methods for HPV detection.
  
  
  METHODS
  A total of 450 males, 14-59 years old, were randomly assigned to one of three genital sampling methods: (1) dry polyester-tipped swab; (2) dry foam swab; and (3) emery paper and wetted polyester-tipped swab. Samples were both self-collected and collected by a clinician. Subjects were queried on the acceptability of sampling methods. HPV was genotyped using an L1 consensus PCR assay.
  
  
  RESULTS
  Specimen adequacy (92-96%, p=0.28) and HPV detection (44-49%, p=0.68) were comparable across the three methods. Concordance for HPV detection was observed between self- and clinician-collected specimen pairs for all methods (κ=0.70-0.80). The collection procedure was reported to be very easy by 69% of dry polyester-tipped swab users and 64% of dry foam swab users compared to 48% of emery-wet swab users (p=0.004). Similarly, 43-44% of dry swab and foam users reported the collection to be very comfortable compared to 24% of emery-wet swab users (p=0.002). Pain was reported by 10% of emery-wet swab users compared to 3% and 5% of dry swab and foam users, respectively (p=0.03). Self-collection by the emery-wet swab method required an average of 6 min compared to 3.3-3.5 min for the two dry methods (p<0.0001).
  
  
  CONCLUSIONS
  The dry collection methods are optimal for use in large epidemiologic studies or surveillance efforts based on their acceptability and feasibility.
authors.affiliation: University of Hawaii Cancer Center, Honolulu, HI, USA. brenda@cc.hawaii.edu
authors.forename: Brenda Y
authors.initials: BY
authors.lastname: Hernandez
authors.forename: Lynne R
authors.initials: LR
authors.lastname: Wilkens
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Unger
authors.forename: Martin
authors.initials: M
authors.lastname: Steinau
authors.forename: Lauri
authors.initials: L
authors.lastname: Markowitz
authors.forename: Keiko
authors.initials: K
authors.lastname: Garvin
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Thompson
authors.forename: Yurii B
authors.initials: YB
authors.lastname: Shvetsov
authors.forename: Kristen
authors.initials: K
authors.lastname: O'Dillon
authors.forename: Eileen F
authors.initials: EF
authors.lastname: Dunne
mesh_terms: D000293:Adolescent; D000328:Adult; D005837:Genitalia, Male / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis*; D010342:Patient Acceptance of Health Care; D012646:Self Administration / Q000379:methods*; D013048:Specimen Handling / Q000379:methods*; D055815:Young Adult
keywords: Genital; HPV; Males; Self-sampling