Evaluation of self-collected vaginal specimens for the detection of high-risk human papillomavirus infection and the prediction of high-grade cervical intraepithelial lesions in a high-burden, low-resource setting

Toliman, Pamela J; Kaldor, John; Badman, Steven G; Phillips, Samuel; Tan, Grace Hwei Ching; Brotherton, Jml; Saville, Marion; Vallely, Andrew; Tabrizi, Sepehr N.

doi:10.1016/j.cmi.2018.05.025

Cited by 24 publications

(33 citation statements)

References 17 publications

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“…estimated HPV prevalence and the proportion of positive tests detected by self‐ and clinician‐collected samples. Toliman et al., Nodjikouambaye et al., Senkomago et al., Adler et al., Adamson et al., and Obiri‐Yeboah et al . reported the agreement of HPV detection between self‐ and clinician‐collected samples.…”

Section: Resultsmentioning

confidence: 99%

“…In total, 13 of the included studies were cohort studies, and 8 reported cross‐sectional findings in eligible populations.…”

Section: Resultsmentioning

confidence: 99%

“…For example, Viviano et al., Adamson et al., and Rositch et al . enrolled women with HIV in a cohort study; Toliman et al . recruited women attending cervical cancer screening at clinics; and Senkomago et al .…”

Section: Resultsmentioning

confidence: 99%

“…Nodjikouambaye et al., Viviano et al., Toliman et al., Adler et al., Boggan et al., Broquet et al., Crofts et al., Fall et al., Brandt et al., Saidu et al., Unteit et al., Ogilvie et al., Berner et al., and Tebeu et al . analyzed participants aged 30–49 years attending cervical cancer screening.…”

Section: Resultsmentioning

confidence: 99%

“…In 15 non‐randomized studies, HPV tests on self‐ and clinician‐collected samples were compared. Six studies evaluated self‐sampling by an interviewer‐administered questionnaire, and one compared self‐collected vaginal samples for HPV testing between women in a rural setting and those in an urban setting …”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

A systematic review of self‐sampling for HPV testing in Africa

Nodjikouambaye

Adawaye

Bouassa

et al. 2020

Intl J Gynecology & Obste

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Background: Human papillomavirus (HPV) testing may be feasible for primary cervical cancer screening in low-resource countries. Objective: To compare self-sampling by women with clinician-performed sampling for HPV testing in Africa. Search strategy: MEDLINE, Google scholar, EMBASE, and several journals were searched from 2000 until 2015 using relevant terms. Selection criteria: Selected studies compared self-sampled and clinician-sampled HPV tests. Data collection and analysis: Data extraction forms included description of the type of HPV screening, description of any additional intervention components, study design, sample size, follow-up periods, analytic approach, reported numerical outcomes, results, and limitations.Results: Twenty-five studies were identified. Women of a wide age range were successful at self-sampling in many African countries. More than 95% of self-samples yielded HPV DNA results. The concordance in test results between self-collected samples and clinician-collected samples was reasonably high in most studies. In all studies, the quality of cytology from self-sampling matched that of clinician-sampling. Women were generally positive about self-collection, but noted some concerns. Conclusion: Self-sampling for HPV DNA testing seems to represent a feasible alternative to the Pap test. Further research is needed to provide a solid evidence base to inform using of self-sampling for HPV DNA testing for primary cervical cancer screening. K E Y W O R D SHPV screening; Human papillomavirus; Physician obtained smear; Self-sampling; Sub-Saharan Africa

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Section: Resultsmentioning

confidence: 99%

“…In total, 13 of the included studies were cohort studies, and 8 reported cross‐sectional findings in eligible populations.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

A systematic review of self‐sampling for HPV testing in Africa

Nodjikouambaye

Adawaye

Bouassa

et al. 2020

Intl J Gynecology & Obste

View full text Add to dashboard Cite

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Scaling up cervical cancer prevention in Western Kenya: Treatment access following a community‐based HPV testing approach

Mungo

Ibrahim

Bukusi

et al. 2020

Intl J Gynecology & Obste

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Objective To evaluate access to treatment after community‐based HPV testing as testing within screen‐and‐treat programs has the potential to lower mortality from cervical cancer in low‐resource settings. Methods A prospective cohort study was conducted in western Kenya in 2018. Women aged 25–65 years underwent HPV self‐testing. HPV‐positive women were referred for cryotherapy. Participant data were obtained from questionnaires during screening and treatment. The proportion successfully accessing treatment and variables associated with successful treatment was determined. Results Of the 750 women included, 140 (18.6%) tested positive for HPV. Of them, 135 were notified of their results, of whom 77 (59.2%) sought treatment and 73 (52.1%) received cryotherapy. Women who received treatment had a shorter time from screening to result notification (median 92 days, interquartile range [IQR] 84–104) compared to those who did not (97 days, IQR 89–106; P=0.061). In adjusted analyses, women with a history of cervical cancer screening (odds ratio [OR] 11, 95% confidence interval [CI] 1.42–85.20) and those electing result notification through a home visit (OR 4, 95% CI 1.23–14.17) were significantly more likely to acquire treatment at follow‐up. Conclusion Linkage to treatment after community‐based HPV screening in this population was low, highlighting the need for strategies aimed at strengthening treatment linkage in similar settings.

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Evaluation of p16/Ki-67 dual-stain cytology performed on self-collected vaginal and clinician-collected cervical specimens for the detection of cervical pre-cancer

Toliman

Phillips

Jong

et al. 2020

Clinical Microbiology and Infection

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Objectives: To compare the performance of dual immunostaining of p16INK4a and Ki-67 proteins performed on self-collected vaginal specimens and clinician-collected cervical specimens, and to evaluate the performance of this technique in predicting high-grade disease. Methods: Women aged 30e59 years (n ¼ 1005) were recruited at two well-women clinics in Papua New Guinea. Each woman provided both cervical and vaginal specimens that were tested for high-risk human papillomavirus (hrHPV) DNA using the Xpert HPV Test (Cepheid) at point of care. A subset of paired cervical and vaginal specimens (n ¼ 243) were selected to undergo CINTec® PLUS (Roche) p16/Ki-67 dual-stain cytology and liquid-based cytology (LBC). Results: Fifty-five pairs (22%) were excluded from further analysis because the smears were not assessable. Of the 189 remaining paired specimens, 74 pairs (39.1%) were positive for one or more hrHPV genotypes. When comparing results of the dual stain, the overall percent agreement, positive and negative percent agreements and k value between the cervical and vaginal specimens were 87.8% (CI 82.3 e92.1%), 64.6% (CI 49.5e77.8%), 95.7% (CI 91.0e98.0%) and 0.65 (CI 0.51e0.79%) respectively. The sensitivity of the dual stain performed on the cervical specimen to predict high-grade disease, determined by LBC, was superior to that of the dual stain performed on the vaginal specimen: 100% (CI 84.6e100%) versus 68.2% (CI 45.1e86.1%). Conclusion:Although further evaluation may be warranted, these findings indicate that dual-stain testing of vaginal specimens cannot be advocated as part of cervical screening programmes in lowand middle-income countries. However, dual-stain cytology performed on cervical specimens may have a role in quality assurance in such settings.

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Evaluation of self-collected vaginal specimens for the detection of high-risk human papillomavirus infection and the prediction of high-grade cervical intraepithelial lesions in a high-burden, low-resource setting

Abstract: Xpert HPV, using self-collected vaginal specimens, has sufficient accuracy for use in point-of-care 'test-and-treat' cervical screening strategies in high-burden, low-resource settings.

Cited by 24 publications

References 17 publications

A systematic review of self‐sampling for HPV testing in Africa

A systematic review of self‐sampling for HPV testing in Africa

Scaling up cervical cancer prevention in Western Kenya: Treatment access following a community‐based HPV testing approach

Evaluation of p16/Ki-67 dual-stain cytology performed on self-collected vaginal and clinician-collected cervical specimens for the detection of cervical pre-cancer

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