Vaginal self sampling versus physician cervical sampling for HPV among younger and older women
- Correspondence to: Tina Karwalajtys 75 Frid Street, Hamilton, ON, Canada L8P 4M3;
- Accepted 11 February 2006
Objectives: To estimate the agreement between self collected vaginal swabs and physician collected cervical brush samples for detection of oncogenic human papillomavirus infection (HPV) by the hybrid capture 2 (HC-2) test among women younger and older than 50 years, and to assess women’s preference for sample collection method based on age.
Methods: Consecutive women aged 15–49 years due for a 1 year visit in a prevalence study of carcinogenic HPV and a new sample of women aged 50 years and older attending their family physicians for cervical screening, in Ontario, Canada, performed vaginal self sampling and underwent physician cervical sampling and cervical cytology. Women completed a self administered questionnaire on demographics and preference for sampling method.
Results: Among the 307 women aged 15–49 years, the prevalence of HPV was 20.8% (64/307) and 17.6% (54/307) in the vaginal and cervical specimens, respectively. Among the women aged 50 years and older, prevalence was 9.9% (15/152) and 8.6% (13/152), respectively. Kappa for agreement between sample collection methods was 0.54 for the younger and 0.37 for the older women (both p<0.001). Nearly half of the women preferred self sampling or had no preference.
Conclusions: There was fair agreement between self collected vaginal and physician collected cervical specimens for detecting carcinogenic HPV in younger and older women. Vaginal sampling for HPV appears to be promising as a primary screening strategy for cervical cancer prevention programmes in low resource settings in developed and developing countries.
Funding sources: Funding was provided as a research grant by the Division of STD Prevention and Control, Bureau of HIV/AIDS and STD, Health Canada, Ottawa, Canada and an unrestricted research grant by the Pharmaceuticals Division, 3M Corporation, Minneapolis, Minn, USA. The HC-2 kits were provided at no charge by Digene Corporation, Gaithersburg, Md.
Competing interests: There are no competing interests to declare.
Ethical approval: The studies were approved by the St Joseph’s Healthcare Research Ethics Board, Hamilton, Canada.