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Vaginal Self-Sampling for Human Papillomavirus Infection as a Primary Cervical Cancer Screening Tool in a Haitian Population.

dc.contributor.author Beauvais, HJ
dc.contributor.author Boggan, Joel
dc.contributor.author Chakhtoura, N
dc.contributor.author Henderson, G
dc.contributor.author McCarthy, Schatzi H
dc.contributor.author Smith, JS
dc.contributor.author Walmer, DK
dc.coverage.spatial United States
dc.date.accessioned 2017-05-27T17:52:52Z
dc.date.available 2017-05-27T17:52:52Z
dc.date.issued 2015-11
dc.identifier https://www.ncbi.nlm.nih.gov/pubmed/26462192
dc.identifier 00007435-201511000-00013
dc.identifier.uri https://hdl.handle.net/10161/14596
dc.description.abstract BACKGROUND: Human papillomavirus (HPV) testing as primary cervical cancer screening has not been studied in Caribbean women. We tested vaginal self-collection versus physician cervical sampling in a population of Haitian women. METHODS: Participants were screened for high-risk HPV with self-performed vaginal and clinician-collected cervical samples using Hybrid Capture 2 assays (Qiagen, Gaithersburg, MD). Women positive by either method then underwent colposcopy with biopsy of all visible lesions. Sensitivity and positive predictive value were calculated for each sample method compared with biopsy results, with κ statistics performed for agreement. McNemar tests were performed for differences in sensitivity at ≥cervical intraepithelial neoplasia (CIN)-I and ≥CIN-II. RESULTS: Of 1845 women screened, 446 (24.3%) were HPV positive by either method, including 105 (5.7%) only by vaginal swab and 53 (2.9%) only by cervical swab. Vaginal and cervical samples were 91.4% concordant (κ = 0.73 [95% confidence interval, 0.69-0.77], P < 0.001). Overall, 133 HPV-positive women (29.9%) had CIN-I, whereas 32 (7.2%) had ≥CIN-II. The sensitivity of vaginal swabs was similar to cervical swabs for detecting ≥CIN-I (89.1% vs. 87.9%, respectively; P = 0.75) lesions and ≥CIN-II disease (87.5% vs. 96.9%, P = 0.18). Eighteen of 19 cases of CIN-III and invasive cancer were found by both methods. CONCLUSIONS: Human papillomavirus screening via self-collected vaginal swabs or physician-collected cervical swabs are feasible options in this Haitian population. The agreement between cervical and vaginal samples was high, suggesting that vaginal sample-only algorithms for screening could be effective for improving screening rates in this underscreened population.
dc.language eng
dc.relation.ispartof Sex Transm Dis
dc.relation.isversionof 10.1097/OLQ.0000000000000345
dc.subject Adolescent
dc.subject Adult
dc.subject Cervical Intraepithelial Neoplasia
dc.subject DNA, Viral
dc.subject Early Detection of Cancer
dc.subject Feasibility Studies
dc.subject Female
dc.subject Haiti
dc.subject Humans
dc.subject Mass Screening
dc.subject Papillomaviridae
dc.subject Papillomavirus Infections
dc.subject Predictive Value of Tests
dc.subject Self Care
dc.subject Sensitivity and Specificity
dc.subject Specimen Handling
dc.subject Uterine Cervical Neoplasms
dc.subject Vaginal Smears
dc.title Vaginal Self-Sampling for Human Papillomavirus Infection as a Primary Cervical Cancer Screening Tool in a Haitian Population.
dc.type Journal article
pubs.author-url https://www.ncbi.nlm.nih.gov/pubmed/26462192
pubs.begin-page 655
pubs.end-page 659
pubs.issue 11
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Institutes and Provost's Academic Units
pubs.organisational-group Medicine
pubs.organisational-group Medicine, General Internal Medicine
pubs.organisational-group School of Medicine
pubs.publication-status Published
pubs.volume 42
dc.identifier.eissn 1537-4521


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