Human papillomavirus detection for cervical cancer prevention with polymerase chain reaction in self-collected samples

Am J Obstet Gynecol. 2002 May;186(5):962-8. doi: 10.1067/mob.2002.122390.


Objective: We studied the usefulness of self-sampling in cervical cancer prevention.

Study design: A cross-sectional study was undertaken at screening services in Recife (Brazil); 253 women aged 16 to 88 years were included. Participants were randomly selected from a high-risk population for cervical neoplasia. All participants collected a self-sample with a cotton-tipped swab by rotating it against the vaginal epithelium and, possibly, the cervix. Physician-collected samples from the ectocervix and endocervix, respectively, with an Ayre's spatula and a Cytobrush endocervical brush (Medscand) were followed by thorough colposcopy. Human papillomaviruses were detected by consensus polymerase chain reaction and typed by restriction fragment length polymorphism.

Results: The difference among human papillomavirus results in samples that were self-collected versus physician collected was significant (P <.03). The agreements were poor among patients with cervical intraepithelial neoplasia (CIN) grade 3 (kappa <0.29) and cervical cancer (kappa < 0.10). Self-sampling missed 50% more cancers than did physician sampling (P =.04).

Conclusion: Self-sampling with a cotton-tipped swab for human papillomavirus detection is not a safe method for the collection of samples that are aimed at primary cervical cancer screening.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Equipment Design
  • Female
  • Humans
  • Mass Screening
  • Middle Aged
  • Papillomaviridae / isolation & purification*
  • Physicians
  • Polymerase Chain Reaction*
  • Self Care*
  • Specimen Handling / instrumentation
  • Specimen Handling / methods*
  • Uterine Cervical Neoplasms / prevention & control*