Comparison between professional sampling and self-sampling for HPV-based cervical cancer screening among postmenopausal women

Int J Gynaecol Obstet. 2018 Sep;142(3):359-364. doi: 10.1002/ijgo.12538. Epub 2018 Jun 25.

Abstract

Objective: To investigate whether self-sampling is as reliable as professional sampling for HPV testing and genotype detection among postmenopausal women.

Methods: In the present prospective cross-sectional study, women in Örebro County, Sweden, who had high-risk HPV (hrHPV) and normal cytology results in exit screening tests conducted in between January 1, 2012, and December 31, 2014, were invited to follow-up screenings between February 24, 2015 and May 15, 2015, that included professional sampling and self-sampling. HPV genotypes were identified by a DNA-based assay that could detect 35 HPV genotypes. Findings between the different sampling methods were compared.

Results: Of 143 women who participated, 119 returned a self-sample. Completely concordant results were observed in 67 of these samples when both hrHPV and low-risk HPV genotypes were analyzed. Overall, 99 (83.2%) women had the same clinically relevant finding from both sampling methods. Twenty women had discordant hrHPV results (hrHPV detected in 10 self-samples vs 10 professionally collected samples; Cohen κ 0.66, 95% confidence interval 0.53-0.80). There was no significant difference between the two sampling methods for clinically significant infections (P>0.99) or extended genotyping (P=0.827).

Conclusion: Postmenopausal women could be offered self-sampling devices to increase screening-program coverage while maintaining test quality.

Keywords: HPV; Cervical cancer; Postmenopausal women; Professional sampling; Screening; Self-sample.

Publication types

  • Comparative Study

MeSH terms

  • Cross-Sectional Studies
  • Early Detection of Cancer / methods
  • Female
  • Genotype
  • Humans
  • Middle Aged
  • Papillomaviridae / genetics*
  • Papillomavirus Infections / diagnosis*
  • Papillomavirus Infections / virology
  • Postmenopause
  • Prospective Studies
  • Specimen Handling / methods*
  • Uterine Cervical Neoplasms / diagnosis*
  • Vaginal Smears / methods