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Vaginal Self-Sampling for Human Papillomavirus Infection as a Primary Cervical Cancer Screening Tool in a Haitian Population.

Publication ,  Journal Article
Boggan, JC; Walmer, DK; Henderson, G; Chakhtoura, N; McCarthy, SH; Beauvais, HJ; Smith, JS
Published in: Sex Transm Dis
November 2015

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 κ 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 (κ = 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 sample-only algorithms for screening could be effective for improving screening rates in this underscreened population.

Duke Scholars

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Published In

Sex Transm Dis

DOI

EISSN

1537-4521

Publication Date

November 2015

Volume

42

Issue

11

Start / End Page

655 / 659

Location

United States

Related Subject Headings

  • Vaginal Smears
  • Uterine Cervical Neoplasms
  • Uterine Cervical Dysplasia
  • Specimen Handling
  • Sensitivity and Specificity
  • Self Care
  • Public Health
  • Predictive Value of Tests
  • Papillomavirus Infections
  • Papillomaviridae
 

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MLA
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Boggan, J. C., Walmer, D. K., Henderson, G., Chakhtoura, N., McCarthy, S. H., Beauvais, H. J., & Smith, J. S. (2015). Vaginal Self-Sampling for Human Papillomavirus Infection as a Primary Cervical Cancer Screening Tool in a Haitian Population. Sex Transm Dis, 42(11), 655–659. https://doi.org/10.1097/OLQ.0000000000000345
Boggan, Joel C., David K. Walmer, Gregory Henderson, Nahida Chakhtoura, Schatzi H. McCarthy, Harry J. Beauvais, and Jennifer S. Smith. “Vaginal Self-Sampling for Human Papillomavirus Infection as a Primary Cervical Cancer Screening Tool in a Haitian Population.Sex Transm Dis 42, no. 11 (November 2015): 655–59. https://doi.org/10.1097/OLQ.0000000000000345.
Boggan JC, Walmer DK, Henderson G, Chakhtoura N, McCarthy SH, Beauvais HJ, et al. Vaginal Self-Sampling for Human Papillomavirus Infection as a Primary Cervical Cancer Screening Tool in a Haitian Population. Sex Transm Dis. 2015 Nov;42(11):655–9.
Boggan, Joel C., et al. “Vaginal Self-Sampling for Human Papillomavirus Infection as a Primary Cervical Cancer Screening Tool in a Haitian Population.Sex Transm Dis, vol. 42, no. 11, Nov. 2015, pp. 655–59. Pubmed, doi:10.1097/OLQ.0000000000000345.
Boggan JC, Walmer DK, Henderson G, Chakhtoura N, McCarthy SH, Beauvais HJ, Smith JS. Vaginal Self-Sampling for Human Papillomavirus Infection as a Primary Cervical Cancer Screening Tool in a Haitian Population. Sex Transm Dis. 2015 Nov;42(11):655–659.

Published In

Sex Transm Dis

DOI

EISSN

1537-4521

Publication Date

November 2015

Volume

42

Issue

11

Start / End Page

655 / 659

Location

United States

Related Subject Headings

  • Vaginal Smears
  • Uterine Cervical Neoplasms
  • Uterine Cervical Dysplasia
  • Specimen Handling
  • Sensitivity and Specificity
  • Self Care
  • Public Health
  • Predictive Value of Tests
  • Papillomavirus Infections
  • Papillomaviridae