Cross-sectional Study of Patient- and Physician-Collected Cervical Cytology and Human Papillomavirus

Garcia, Francisco Moacir Pinheiro; Barker, Bel; Santos, Carlos; Brown, Elena Mendez; Nuño, Thomas; Giuliano, Anna R.; Davis, John R.

doi:10.1097/00006250-200308000-00011

Cited by 28 publications

(41 citation statements)

References 17 publications

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“…There is no statistically significant difference in the sensitivity between cytology and either of the two HPV tests. The specificity of cytology is significantly higher than the specificity of the self HPV test (14% higher, 95% CI of [12][13][14][15][16][17] and clinician HPV test (12%, 95% CI of [9][10][11][12][13][14]. The NPVs of cytology and the HPV tests are similar, but the PPV of cytology is higher than the PPV for the HPV tests and the CIs do not overlap.…”

Section: Test Accuracy For Diagnosis Of High-grade Diseasementioning

confidence: 99%

Human papillomavirus testing by self-sampling: assessment of accuracy in an unsupervised clinical setting

et al. 2007

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Objectives To compare the performance and acceptability of unsupervised self-sampling with clinician sampling for high-risk human papillomavirus (HPV) types for the first time in a UK screening setting. Setting Nine hundred and twenty women, from two demographically different centres, attending for routine cervical smear testing Methods Women performed an unsupervised HPV self-test. Immediately afterwards, a doctor or nurse took an HPV test and cervical smear. Women with an abnormality on any test were offered colposcopy.Results Twenty-one high-grade and 39 low-grade cervical intraepithelial neoplasias (CINs) were detected. The sensitivity for high-grade disease (CIN2 þ ) for the self HPV test was 81% (95% confidence interval [CI] 60-92), clinician HPV test 100% (95% CI 85-100), cytology 81% (95% CI 60-92). The sensitivity of both HPV tests to detect high-and low-grade cervical neoplasia was much higher than that of cytology , clinician test 80% [95% CI 68-88], cytology 48% [95% CI 36-61]). For both high-grade alone, and high and low grades together, the specificity was significantly higher for cytology (greater than 95%) than either HPV test (between 82% and 87%). The self-test proved highly acceptable to women and they reported that the instructions were easy to understand irrespective of educational level. Conclusions Our results suggest that it would be reasonable to offer HPV self-testing to women who are reluctant to attend for cervical smears. This approach should now be directly evaluated among women who have been non-attenders in a cervical screening programme.

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Section: Test Accuracy For Diagnosis Of High-grade Diseasementioning

confidence: 99%

Human papillomavirus testing by self-sampling: assessment of accuracy in an unsupervised clinical setting

et al. 2007

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“…Previous studies examined the sensitivity and predictive value of HPV detection by comparing self-collected and physician-collected samples for HPV screening. They found that HPV self-collection was an acceptable and feasible method to confirm cytology results in cervical cancer screening (Garcia et al, 2003. In Thailand, most screening of cervical cancer is done by Pap smear, but few women follow this screening program (Rugpao et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Comparison of Detection Sensitivity for Human Papillomavirus between Self-collected Vaginal Swabs and Physician-collected Cervical Swabs by Electrochemical DNA Chip

Nilyanimit¹,

Wanlapakorn²,

Niruthisard³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Background: Human papillomavirus (HPV) DNA testing is an effective method to screen for precancerous changes in the cervix. Samples from self-collection rather than Pap smear can potentially be used to test for HPV as they are more acceptable and preferred for use in certain settings. The objective of this study was to compare HPV DNA testing from self-collected vaginal swabs and physician-collected cervical swabs. Materials and Methods: A total of 101 self-collected vaginal and physician-collected cervical swabs of known cytology from Thai women were tested by electrochemical DNA chip assay. The specimens were divided into 4 groups: 29 with normal cytology, 14 with atypical squamous cells of undetermined significance (ASCUS), 48 with lowgrade squamous intraepithelial lesion (LSIL), and 10 with high-grade squamous intraepithelial lesion (HSIL). Results: Positive detection rates of HPV from self-collected swabs were similar to those from physician-collected swabs. Among specimens with abnormal cytology, HPV was found in 50% of self-collected swabs and 47.2% of physician-collected swabs. In specimens with normal cytology, 17.2% of self-collected swabs and 24.1% of physician-collected swabs were positive for HPV. Concordance was relatively high between results from selfcollected and physician-collected samples. The most common HPV genotype detected was HPV 51. Conclusions: HPV DNA testing using self-collected swabs is a feasible alternative to encourage and increase screening for cervical cancer in a population who might otherwise avoid this important preventive examination due to embarrassment, discomfort, and anxiety.

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“…At present, cytodiagnostic testing using the selfcollection method is not recommended for cervical cancer screening because of insufficient the amount of cells for cytodiagnosis and the test sensitivity is extremely inferior to that of the direct method of collection by a physician, resulting in many indeterminate specimens (Belinson et al, 2001) (Belinson et al, 2003) (Garcia et al, 2003) (Salmerón et al, 2003). However, for accurate cervical cancer screening, regardless of the screening method, the following three points must be followed: (1) an appropriate sample must be collected; (2) the specimens must be prepared correctly; and (3) a cytotechnologist should observe the specimens.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, new measures to raise the cervical cancer screening rate have included a drive to initiate cytodiagnostic testing by distributing self-collection devices and physicians directly collecting cervical swabs from patients. However, the accuracy of cytodiagnostic tests through self-collection is much lower than the direct method because the absolute number of cells on the smear is low and reports have indicated that there are several defective specimens due RESEARCH ARTICLE to sampling errors (Belinson et al, 2001;Belinson et al, 2003;Garcia et al, 2003;Salmerón et al, 2003). Consequently, cytodiagnostic tests using self-collected specimens are not recommended by the Japan Society of Obstetrics and Gynecology.…”

Section: Introductionmentioning

confidence: 99%

Improved Accuracy of Cytodiagnosis using the Kato Self-Collection Devise: the Usefulness of Smear Preparation in Liquid-based Cytology Methods

Okayama

Okodo²,

Fujii³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Object: In the present study, we compared the positive cytodiagnostic test rates with discrepancies using self-collection devices for cervical cancer screening. We made this survey to examine whether or not our selfsmear preparation method using the Kato self-collection device contributed to an improved rate of detecting atypical cells compared with existing recommended preparation methods. Methods: Specimens were collected at 14 facilities handling self-collection methods, and samples were collected by a physician in 2 facilities. The chisquared test was performed using the SPSS ver. 20 statistical software to determine the relationships between the positive cytodiagnostic rate, specimen preparation methods, and self-collection devices. Results: Collecting cells using the Kato self-collection device and preparing liquid-based specimens, we obtained a significantly higher rate of positive cytodiagnosis and our results were equal to those obtained with the direct method. Conclusions: Taking into consideration increased needs for screening using the self-collection method in future, with even more improved test accuracy, a screening test that is acceptable to society needs to be established.

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Cross-sectional Study of Patient- and Physician-Collected Cervical Cytology and Human Papillomavirus

Cited by 28 publications

References 17 publications

Human papillomavirus testing by self-sampling: assessment of accuracy in an unsupervised clinical setting

Human papillomavirus testing by self-sampling: assessment of accuracy in an unsupervised clinical setting

Comparison of Detection Sensitivity for Human Papillomavirus between Self-collected Vaginal Swabs and Physician-collected Cervical Swabs by Electrochemical DNA Chip

Improved Accuracy of Cytodiagnosis using the Kato Self-Collection Devise: the Usefulness of Smear Preparation in Liquid-based Cytology Methods

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