Archives of Gynecology and Obstetrics

, Volume 290, Issue 6, pp 1207–1213

HPV detection in a self-collected vaginal swab combined with VIA for cervical cancer screening with correlation to histologically confirmed CIN

  • Ebtesam M. Kamal
  • Gamal Abbas El Sayed
  • Manal M. El Behery
  • Gehan A El Shennawy
Gynecologic Oncology

DOI: 10.1007/s00404-014-3321-6

Cite this article as:
Kamal, E.M., El Sayed, G.A., El Behery, M.M. et al. Arch Gynecol Obstet (2014) 290: 1207. doi:10.1007/s00404-014-3321-6

Abstract

Aim

To first compare the accuracy of self-, Physician-HPV testing and VIA as standalone screening tests; and second to compare the accuracy of Self-HPV positive test triaged with VIA with the different standalone screening tests as colposcopy and histologically confirmed CIN for cervical cancer screening in low-resource settings

Methods

1,601 women in Sharkya Governerate, Egypt concurrently received HPV DNA testing [Hybrid Capture 2 (HC2) assay] for self-collected and physician-obtained samples, and VIA. Women who tested positive for HPV DNA or VIA received colposcopy and biopsy.

Results

Percentage of women testing positive was 84.8 % on Self-HPV, 87.8 % on Physician-HPV, and 76.8 % on VIA. Test positivity increased in all screening methods with increasing severity of histopathologic diagnosis. Physician-HPV and HPV testing on a self-sample showed a very good agreement for HPV testing results [κ = 0.89 (95 % CI = 0.52–0.79)]; no statistically significant variation between age groups in the sensitivities of HPV testing on a self-sample, Physician-HPV testing for detecting CIN2 or CIN3 lesions. Conversely, VIA sensitivity was lower in detecting CIN2 and CIN3 than HPV testing on a self-sample and decreased significantly in the older age groups. HPV testing on a self-sample positive combined with VIA increases specificity to 98.1 % for CIN2 and 99.4 % for CIN3, and decreased colposcopy referral rate to 2.5 %.

Conclusion

HPV testing on a self-sample is more accurate than VIA and as accurate as clinician-HPV testing for cervical cancer in low-resource settings.

Keywords

HPV testing on a self-sampleVIACervical cancer screeningColposcopy

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Ebtesam M. Kamal
    • 1
  • Gamal Abbas El Sayed
    • 1
  • Manal M. El Behery
    • 1
  • Gehan A El Shennawy
    • 2
  1. 1.Obstetrics and Gynecology Department, Faculty of MedicineZagazig UniversityZagazigEgypt
  2. 2.Microbiology and Immunology Department, Faculty of MedicineZagazig UniversityZagazigEgypt