Daily self-sampling for high-risk human papillomavirus (HR-HPV) testing.
BACKGROUND
Self-sampling for HPV as part of primary screening is a well-tolerated method for women not attending organized Pap smear screening and could increase coverage of cervical cancer screening.


OBJECTIVE
To investigate if the prevalence of HR-HPV varies from day to day in infected women and if one single sample is reliable for detecting an ongoing infection.


METHODS
This is a prospective cohort study on 12 premenopausal and 13 postmenopausal women performing daily self-sampling for HR-HPV testing. They were all HR-HPV-positive 1-3 months ago. Postmenopausal women were sampled for 28 days and premenopausal women sampled during bleeding-free days in one menstrual cycle. A possible difference in viral load between the estrogen-dominated proliferative phase and the progesterone-dominated secretory phase was analyzed.


CONCLUSIONS
Consistent results throughout the sampling period were observed for 19 women, with either a daily presence of HPV (14 women) or no HPV at all during the sampling period (5 women). Of 607 samples from 25 women, 596 were consistently positive or negative for HPV during the sampling period and 11 were inconsistent (2%). There was no difference in HPV copy number between the estrogen dominated proliferative or progesterone dominated secretory menstrual cycle phases. The major finding was a high degree of consistency concerning HR-HPV positivity and negativity of HR-HPV in vaginal fluid during a sustained period of daily self-sampling. It does not appear to matter whether the sample is collected in the proliferative or secretory phase.
Department of Women's and Children's Health, Uppsala University, SE-751 85 Uppsala, Sweden. Electronic address: Karin.Sanner@kbh.uu.se.
Karin
K
Sanner
Department of Women's and Children's Health, Uppsala University, SE-751 85 Uppsala, Sweden.
Ingrid
I
Wikström
Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, SE-751 08 Uppsala, Sweden.
Inger
I
Gustavsson
Department of Women's and Children's Health, Uppsala University, SE-751 85 Uppsala, Sweden.
Erik
E
Wilander
Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, SE-751 08 Uppsala, Sweden.
Julia Hedlund
JH
Lindberg
Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, SE-751 08 Uppsala, Sweden.
Ulf
U
Gyllensten
Department of Women's and Children's Health, Uppsala University, SE-751 85 Uppsala, Sweden.
Matts
M
Olovsson
D001826:Body Fluids / Q000821:virology*; D015331:Cohort Studies; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000821:virology*; D017698:Postmenopause; D017697:Premenopause; D011446:Prospective Studies; D016353:Self-Examination; D012680:Sensitivity and Specificity; D013048:Specimen Handling / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000821:virology*; D014621:Vagina / Q000821:virology; D019562:Viral Load
Cervical cancer; Human papilloma virus (HPV); Repeated sampling; Screening; Self-sampling