Randomised study shows that repeated self-sampling and HPV test has more than two-fold higher detection rate of women with CIN2+ histology than Pap smear cytology

Abstract

This corrects the article DOI: 10.1038/bjc.2017.85.

Randomised study of HPV prevalence and detection of CIN2+ in vaginal self‐sampling compared to cervical specimens collected by medical personnel

“…We have previously shown in a smaller cohort study based on the follow‐up of women that were previously known to be HPV positive, that vaginal self‐sampling and using the FTA card is equally efficient as assisted sampling on the cervix for identification of HPV and histology defined high‐grade cervical lesions In the present study, a population‐based randomised study design was used to assess the efficiently of self‐sampling for detection of HPV and high‐grade cervical lesions. Recently we have also shown that repeated self‐sampling on FTA cards for HPV test detects more than two‐fold as many women with CIN2+ as Pap smear cytology . HPV typing results based on FTA cards shows consistent results across menstrual cycle phases and calendar time .…”

“…There was a higher participation rate in the SS arm, in line with our recent published study (women aged 30-49) showing a higher participation rate for women invited to self-sampling as compared to those invited for Pap smear cytology testing. 22 The lower participation in the AS arm can be explained by the fact that some women were wrongly offered the Pap smear cytology instead of the HPV test, since the transition to the new strategy started at the same time as the present study. In addition, when summarising data from the regular invitation system we found that fewer women in the AS arm than expected received an invitation, and those women were excluded as not eligible, which could have affected the calculated participation rate for the AS arm.…”

“…However, the sampling brush used to collect the sample differed between study arms. In the AS arm a cytobrush was used, consistent with the present routines in the screening program in Uppsala County, while in SS arm the soft VIBA brush was used, as previously used in a number of studies …”

“…In the AS arm a cytobrush was used, consistent with the present routines in the screening program in Uppsala County, while in SS arm the soft VIBA brush was used, as previously used in a number of studies. 17,18,[20][21][22]29 The sensitivity for detection of HPV in vaginal self-samples has been reported to be lower as compared to cliniciancollected samples 29 and the recommendation is to use a PCRbased HPV assay with high analytical sensitivity which is able to detect low HPV copy numbers. The real-time PCR-based assay (hpVIR) used in present study is able to reliably detect both human nuclear DNA and HPV DNA copy numbers down to ten copies per PCR.…”

Identification of Candidate Plasma Protein Biomarkers for Cervical Cancer Using the Multiplex Proximity Extension Assay

“…To increase the specificity of screening, and distinguish between transient and persistent HPV infections, the HPV-test can be repeated 4 -6 months after the primary screening test. This has been shown to reduce the number of HPV infections requiring management by about 40% (11,12). An alternative way is to combine the HPV test with additional biomarkers indicating the persistence of infection or identifying early signs of cervical dysplasia (2,3).…”