TY - JOUR
T1 - Vaginal self-sampling for human papillomavirus infection as a primary cervical cancer screening tool in a haitian population
AU - Boggan, Joel C.
AU - Walmer, David K.
AU - Henderson, Gregory
AU - Chakhtoura, Nahida
AU - McCarthy, Schatzi H.
AU - Beauvais, Harry J.
AU - Smith, Jennifer S.
N1 - Publisher Copyright:
© 2015 American Sexually Transmitted Diseases Association All rights reserved.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2015
Y1 - 2015
N2 - 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 k 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 (k = 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 samplëConly algorithms for screening could be effective for improving screening rates in this underscreened population.
AB - 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 k 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 (k = 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 samplëConly algorithms for screening could be effective for improving screening rates in this underscreened population.
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U2 - 10.1097/OLQ.0000000000000345
DO - 10.1097/OLQ.0000000000000345
M3 - Article
C2 - 26462192
AN - SCOPUS:84944238345
VL - 42
SP - 655
EP - 659
JO - Sexually Transmitted Diseases
JF - Sexually Transmitted Diseases
SN - 0148-5717
IS - 11
ER -