title: Improvement of Gynecological Screening of Female Renal Transplant Recipients by Self-Sampling for Human Papillomavirus Detection.
abstract: OBJECTIVE
  Female renal transplant recipients (RTRs) have increased risk for developing human papillomavirus (HPV)-related (pre)malignancies of the lower genital tract. Annual cervical screening is advised for RTRs, but the participation rate is low. The aim of this study is to investigate whether HPV self-sampling is suitable for gynecological screening of RTRs to increase participation rate.
  
  
  METHODS
  A large cohort of 253 RTRs was investigated for the prevalence of HPV. All participants received a device for a cervicovaginal self-sample. Questionnaires were sent to assess the experience with this device. High-risk (hrHPV) presence was determined with the SPF10-LiPA25 system and GP5+/6+ PCR. HrHPV-positive patients underwent gynecological examination.
  
  
  RESULTS
  More than 90% of the patients rated their experience with the self-sample device as good to excellent, and 77% preferred self-sampling over a physician taken sample. Approximately thirty-five of 217 women tested hrHPV positive with SPF10- LiPA25, and 22 tested positive with the GP5+/6+ PCR. Eleven hrHPV-positive patients had clinically relevant gynecological abnormalities, and they all tested positive with GP5+/6+ PCR.
  
  
  CONCLUSIONS
  Self-sampling is clinically applicable in a gynecological screening and is preferred by female RTRs. Therefore, self-sampling could be implemented with the aim to increase the participation rate of female RTRs in yearly gynecological screening.
authors.affiliation: 1Departments of Obstetrics and Gynecology, 2Nephrology, 3Dermatology, and 4Medical Microbiology, Radboud University Medical Center, Nijmegen; and 5Department of Obstetrics and Gynecology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Floor
authors.initials: F
authors.lastname: Hinten
authors.forename: Luuk B
authors.initials: LB
authors.lastname: Hilbrands
authors.forename: Kim A
authors.initials: KA
authors.lastname: Meeuwis
authors.forename: Muriël C
authors.initials: MC
authors.lastname: van Bergen-Verkuyten
authors.forename: Brigitte F
authors.initials: BF
authors.lastname: Slangen
authors.forename: Michelle M
authors.initials: MM
authors.lastname: van Rossum
authors.forename: Janette
authors.initials: J
authors.lastname: Rahamat-Langendoen
authors.forename: Leon F
authors.initials: LF
authors.lastname: Massuger
authors.forename: Joanne A
authors.initials: JA
authors.lastname: de Hullu
authors.forename: Willem J
authors.initials: WJ
authors.lastname: Melchers
mesh_terms: D000328:Adult; D000368:Aged; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000175:diagnosis*; D010342:Patient Acceptance of Health Care; D016353:Self-Examination / Q000379:methods*; D013048:Specimen Handling / Q000379:methods*; D011795:Surveys and Questionnaires; D066027:Transplant Recipients; D055815:Young Adult