Comparability of Self-Collected Vaginal Swabs and Physician-Collected Cervical Swabs for Detection of Human Papillomavirus Infections in Rakai, Uganda

Sex Transm Dis. 2007 Jul;34(7):429-36. doi: 10.1097/01.olq.0000243623.67673.22.

Abstract

Objective: The objective of this study was to compare human papillomavirus (HPV) DNA testing between self-administered vaginal swabs and physician-administered cervical swabs in women from rural Rakai District, Uganda.

Study design: Between 2002 and 2003, women from a population-based cohort participated in an HPV study. Women collected self-administered vaginal swabs and were also offered a pelvic examination, which included physician-collected cervical samples.

Methods: Hybrid-capture 2 was used to determine carcinogenic HPV status. Polymerase chain reaction was used to determine HPV genotypes. Unweighted kappa statistics were used to determine agreement.

Results: Compliance with self-collected swabs was > or =86%; however, only 51% accepted a pelvic examination. Carcinogenic HPV prevalence was 19% in self-collected and 19% in physician-collected samples. Agreement among paired observations was 92% with a kappa of 0.75. Kappa between self- and physician-collected samples was similar in HIV strata (k = 0.71 and 0.75 for HIV-positive and HIV-negative, respectively).

Discussion: In this community-based setting, detection of carcinogenic HPV was comparable among self- and physician-administered samples. Self-collection is a feasible and accurate means of obtaining HPV samples from women in resource-poor settings or persons reluctant to undergo a pelvic examination.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cervical Intraepithelial Neoplasia / etiology
  • Cervical Intraepithelial Neoplasia / prevention & control
  • Cohort Studies
  • DNA, Viral / analysis
  • Female
  • Humans
  • Middle Aged
  • Outcome Assessment, Health Care
  • Papillomaviridae / genetics
  • Papillomaviridae / isolation & purification
  • Papillomavirus Infections / diagnosis*
  • Papillomavirus Infections / epidemiology
  • Papillomavirus Infections / prevention & control
  • Polymerase Chain Reaction
  • Practice Patterns, Physicians'*
  • Prevalence
  • Self-Examination*
  • Specimen Handling
  • Uganda / epidemiology
  • Uterine Cervical Neoplasms / diagnosis
  • Uterine Cervical Neoplasms / prevention & control
  • Vaginal Smears / methods*

Substances

  • DNA, Viral