title: Can Human Papillomavirus DNA Self-sampling be an Acceptable and Reliable Option for Cervical Cancer Screening in Female Sex Workers?
abstract: BACKGROUND
  The causal relation between human papillomavirus (HPV) and cervical cancer has enabled HPV self-sampling to be envisaged as a possible screening method.
  
  
  OBJECTIVE
  The aim of this study is to explore the acceptability and reliability of HPV DNA self-sampling as an alternative option for cervical screening among female sex workers.
  
  
  METHODS
  Sixty-eight participants carried out self-sampling for HPV testing, gave a clinician-obtained sample for HPV testing, and a Papanicolaou test. After the samplings, the participants were questioned on the acceptability of the tests.
  
  
  RESULTS
  Most participants (65.6%) preferred to adopt HPV DNA self-sampling in the future; in particular, those without previous experience of Papanicolaou tests marginally significantly preferred self-sampling (86.7%, P = .055). The overall crude agreement in HPV detection rates between clinician and HPV DNA self-sampling was 85.3% (58/68), with a κ of 0.69 (95% confidence interval, 0.51-0.87). The sensitivity and specificity of self-collected samples were 66.7% and 66.1%, respectively, and the positive and negative predicted values were 24.0% and 92.5%, respectively. The prevalence of HPV was slightly higher in self-collected samples (39.7%, 27/68) than in clinician-collected samples (36.8%, 25/68). The participants expressed positive attitudes toward self-sampling but were less confident in their skills of self-sampling compared with clinicians (70.6% versus 91.2%).
  
  
  CONCLUSIONS
  The findings showed that self-sampling could be incorporated into current cervical cancer screening approaches.
  
  
  CONCLUSIONS
  Self-sampling could potentially increase compliance to cervical cancer screening and thus reduce the morbidity and mortality from cervical cancer. Further research and education on self-sampling will be required for women of diverse backgrounds.
authors.affiliation: Author Affiliations: The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
authors.forename: Eliza L Y
authors.initials: ELY
authors.lastname: Wong
authors.forename: Annie W L
authors.initials: AWL
authors.lastname: Cheung
authors.forename: Fenwei
authors.initials: F
authors.lastname: Huang
authors.forename: Josette S Y
authors.initials: JSY
authors.lastname: Chor
mesh_terms: D000328:Adult; D004279:DNA, Viral / Q000032:analysis; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D061809:Human Papillomavirus DNA Tests; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000175:diagnosis*; D010342:Patient Acceptance of Health Care; D015203:Reproducibility of Results; D012648:Self Care; D012680:Sensitivity and Specificity; D060386:Sex Workers / Q000523:psychology* / Q000706:statistics & numerical data; D013048:Specimen Handling / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D004279:DNA, Viral