Prevalence of type-specific human papillomavirus in endocervical, upper and lower vaginal, perineal and vaginal self-collected specimens: Implications for vaginal self-collection

✍ Scribed by Jerome L. Belinson; Shangying Hu; Mayineur Niyazi; Robert G. Pretorius; He Wang; Chen Wen; Jennifer S. Smith; Jing Li; Frank J. Taddeo; Raoul J. Burchette; You-Lin Qiao

• Publisher: John Wiley and Sons
• Year: 2009
• Tongue: French
• Weight: 140 KB
• Volume: 127
• Category: Article
• ISSN: 0020-7136
• DOI: 10.1002/ijc.25144

✦ Synopsis

Abstract

To determine why a vaginal self‐collection tested for high‐risk human papillomavirus (HR‐HPV) by Hybrid Capture 2® (hc2) has lower sensitivity and specificity for cervical intraepithelial neoplasia Grade 2 or worse (≥CIN 2), we collected 5 specimens (endocervix, upper and lower vagina, perineum, vaginal self‐collection) from 2,625 women. Endocervical and self‐collected specimens had HR‐HPV tests by hc2. All 5 anogenital specimens were tested for 37 HPV genotypes [Linear Array®, (LA)] from 397 women hc2 positive in endocervical or self‐collected specimens and for a randomly selected 71 of 2,228 women hc2 negative on both specimens. Three hundred nintey‐five women who screened positive by hc2 or had abnormal cytology underwent colposcopic evaluation. Of 47 women with ≥CIN 2, hc2 was positive in 97.9% (46/47) of endocervical and 80.9% (38/47), p = 0.008 of self‐collected specimens. Seven of 9 women with ≥CIN 2 and negative self‐collected hc2 tests were positive for HR‐HPV by LA. Of 2,578 women without ≥CIN 2, hc2 was positive in 9.8% (253/2,578) of endocervical and 11.4% (294/2,578), p = 0.001 of self‐collected specimens. Of the 41 more women without ≥CIN 2 that tested hc2 positive on the self‐collected but negative on endocervical specimen, LA tested positive for HR‐HPV in 24, negative for HPV in 11 and negative for HR‐HPV but positive for low‐risk HPV in 6. Lower sensitivity of self‐collected specimens is secondary to lower levels of vaginal HR‐HPV. The principal cause of the lower specificity of self‐collected specimens is HR‐HPV present solely in the vagina, which is not associated with ≥CIN 2.