Non-speculum clinician-taken samples for human papillomavirus testing: a cross-sectional study in older women.
Br J Gen Pract
; 72(721): e538-e545, 2022 08.
Article
in En
| MEDLINE
| ID: mdl-35667684
ABSTRACT
BACKGROUND:
Cervical cancer incidence and mortality are high in women aged ≥65 years, despite the disease being preventable by screening. Speculum-based screening can become more uncomfortable after the menopause.AIM:
To examine test performance and acceptability of human papillomavirus (HPV) testing on clinician-collected vaginal samples without a speculum (non-speculum). DESIGN ANDSETTING:
Cross-sectional study in 11 GP practices and four colposcopy clinics in London, UK, between August 2017 and January 2019.METHOD:
Non-speculum and conventional (speculum) samples were collected from women aged ≥50 years attending for a colposcopy (following a speculum HPV-positive screening result) or women aged ≥35 years (with confirmed cervical intraepithelial neoplasia (CIN) 2+), and women aged 50-64 years attending routine screening. Sensitivity to CIN2+ was assessed among women with confirmed CIN2+ (colposcopy). Specificity to HPV relative to speculum sampling and overall concordance was assessed among women with negative cytology (routine screening).RESULTS:
The sensitivity of non-speculum sampling for detecting CIN2+ was 83.3% (95% confidence interval [CI] = 60.8 to 94.2) (n = 15/18). There was complete concordance among women with positive CIN2+ who had a speculum sample ≤91 days prior to the non-speculum sample (n = 12). Among 204 women with negative cytology, the specificity to HPV was 96.4% (95% CI = 92.7 to 98.5), with 96.6% concordant results (κ 72.4%). Seventy-one percent (n = 120/170) of women preferred a non-speculum sample for their next screen.CONCLUSION:
HPV testing on non-speculum clinician-taken samples is a viable approach that warrants further exploration in larger studies. Overall test performance was broadly comparable with that of self-sampling.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Uterine Cervical Neoplasms
/
Papillomavirus Infections
/
Alphapapillomavirus
Type of study:
Diagnostic_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limits:
Aged
/
Female
/
Humans
Language:
En
Journal:
Br J Gen Pract
Year:
2022
Document type:
Article
Affiliation country:
Estados Unidos