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

Boggan, Joel C

Walmer, David K

Henderson, Gregory

Chakhtoura, Nahida

McCarthy, Schatzi H

Beauvais, Harry J

Smith, Jennifer S

United States

2017-05-27T17:52:52Z

2017-05-27T17:52:52Z

2015-11

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.

https://www.ncbi.nlm.nih.gov/pubmed/26462192

00007435-201511000-00013

1537-4521

https://hdl.handle.net/10161/14596

eng

Ovid Technologies (Wolters Kluwer Health)

Sex Transm Dis

10.1097/OLQ.0000000000000345

Adolescent

Adult

Cervical Intraepithelial Neoplasia

DNA, Viral

Early Detection of Cancer

Feasibility Studies

Female

Haiti

Humans

Mass Screening

Papillomaviridae

Papillomavirus Infections

Predictive Value of Tests

Self Care

Sensitivity and Specificity

Specimen Handling

Uterine Cervical Neoplasms

Vaginal Smears

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

Journal article

Boggan, Joel C|0000-0003-3564-2807

Walmer, David K|0000-0003-4582-9333

https://www.ncbi.nlm.nih.gov/pubmed/26462192

655

659

11

Clinical Science Departments

Duke

Institutes and Provost's Academic Units

Medicine

Medicine, General Internal Medicine

School of Medicine

Published

42