Abstract
Background. Most of women diagnosed as having cervical cancer have not participated in organized cytological screening. Aim. A study was conducted to evaluate the accuracy of human papilloma virus testing by self-collected vaginal samples in comparison to regular cytological screening. The agreement of hybrid capture 2 assay and polymerase chain reaction assay for detection of human papilloma virus DNA in self-collected vaginal samples and clinician-obtained cervical smears was investigated. Method. Forty-three women aged 23–58 years admitted for further examination due to previous positive cytology in the organized screening participated in self-collecting of vaginal samples with a novel self-sampling device. During the visit a clinician also collected a cervical smear using a cytobrush. The vaginal samples collected with the self-sampling device were analyzed for high-risk human papilloma virus with the hybrid capture 2 assay technique and the cervical smears were Pap-stained, examined cytologically and after that reanalyzed for human papilloma virus DNA using a polymerase chain reaction assay. Result. The vaginal samples were positive for high-risk human papilloma virus in 37% of the cases using hybrid capture 2 assay. Twelve of the 43 Pap smears showed positive cytology (ASCUS-CIN 3), of which 4 showed CIN 2–3. When polymerase chain reaction assay was performed, human papilloma virus DNA was detected in 40% of the glass slides. The agreement between cytology and the two human papilloma virus testing techniques was 67–74% (kappa 0.27–0.45) and the agreement between the two human papilloma virus tests was 70% (kappa 0.36). Conclusion. Testing for high-risk human papilloma virus can identify more women at risk of developing cervical cancer than cytology irrespective of the sampling method. Furthermore, offering a self-sampling device for collection of vaginal smear seems to be a useful screening tool for cervical cancer among women not responding to an invitation for smear sampling.
| Acronyms | ||
| HPV | = | human papilloma virus |
| HC2 | = | hybrid capture 2 assay |
| PCR | = | polymerase chain reaction assay |
| SSD | = | self-sampling device |
| ASCUS | = | atypical squamous cells of undetermined significance |
| CIN | = | cervical intraepithelial neoplasia |
| LSIL | = | low-grade squamous intraepithelial lesion |
| HSIL | = | high-grade squamous intraepithelial lesion |
| Acronyms | ||
| HPV | = | human papilloma virus |
| HC2 | = | hybrid capture 2 assay |
| PCR | = | polymerase chain reaction assay |
| SSD | = | self-sampling device |
| ASCUS | = | atypical squamous cells of undetermined significance |
| CIN | = | cervical intraepithelial neoplasia |
| LSIL | = | low-grade squamous intraepithelial lesion |
| HSIL | = | high-grade squamous intraepithelial lesion |