Accuracy of self-collected human papillomavirus samples from Japanese women with abnormal cervical cytology

J Obstet Gynaecol Res. 2017 Apr;43(4):710-717. doi: 10.1111/jog.13258.


Aim: The aim of this study was to assess the accuracy of self-collected vaginal samples compared with physician-collected cervical samples for high-risk human papillomavirus (HPV) testing in Japanese women with abnormal cervical cytology. We also assessed the acceptability of self-collected HPV (sHPV) testing using a questionnaire.

Methods: Women aged 20-69 years (n = 136) attending Yokohama City University Hospital because of abnormal cervical cytology between April 2014 and January 2015 were enrolled in this study. Cervical samples for conventional cytology and physician-collected HPV (pHPV) testing were obtained before colposcopic examination. After this examination, patients were asked to provide a self-sampled vaginal specimen (sHPV) at home, some time between the following day and the next week and to complete a self-sampling acceptability questionnaire.

Results: The overall positive rates of HPV detection with pHPV and sHPV testing were 61.0% (83/136) and 40.4% (55/136), respectively (P < 0.001). sHPV testing had a lower sensitivity compared to pHPV for detection of cervical intraepithelial neoplasia (CIN)2 or worse (CIN2+: 59.4% vs 100%, P < 0.001; CIN3: 66.7% vs 100%, P = 0.248). There were no statistically significant differences in the sensitivity to detect CIN3 among pHPV testing, sHPV testing, and cytology. The self-collecting device had good acceptability.

Conclusion: sHPV testing is a possible technique with which to improve poor cervical cancer screening uptake rates in Japan; however, the sensitivity to detect CIN2+ lesions must improve before it can be a substitute for conventional cytology or pHPV testing. Further large-scale acceptability studies involving non-responders are also needed before practical application.

Keywords: cancer of the cervix; cytology and GYN pathology; human papillomavirus infection and cervical intraepithelial neoplasia.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Japan
  • Middle Aged
  • Papillomaviridae / isolation & purification*
  • Sensitivity and Specificity
  • Uterine Cervical Neoplasms / diagnosis*
  • Vaginal Smears / instrumentation
  • Vaginal Smears / methods
  • Vaginal Smears / standards*
  • Young Adult