Results of the Women's Self-Performed Anal Pap Trial in Human Immunodeficiency Virus–Infected Women

McNeil, Candice J; Kong, Christina S.; Anglemyer, Andrew; Levy, Vivian; Maldonado, Yvonne

doi:10.1097/olq.0000000000000448

Cited by 8 publications

(4 citation statements)

References 16 publications

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“…We agree that gaps in knowledge will pose significant barriers to anal cytology screening whether it be self or provider collected. In our diverse cohort of women living with HIV (WLWH) receiving healthcare in a health department setting, participants found self-collected anal cytology specimens acceptable 2 . Interestingly, there was no difference in preference between self- or clinician-performed specimen collection 2 .…”

mentioning

confidence: 91%

“…In our diverse cohort of women living with HIV (WLWH) receiving healthcare in a health department setting, participants found self-collected anal cytology specimens acceptable. 2 Interestingly, there was no difference in preference between selfor clinician-performed specimen collection. 2 As Rodriguez et al 1 highlighted, a number of factors may contribute to acceptability of self-collected specimens.…”

mentioning

confidence: 96%

“…2 Interestingly, there was no difference in preference between selfor clinician-performed specimen collection. 2 As Rodriguez et al 1 highlighted, a number of factors may contribute to acceptability of self-collected specimens.…”

mentioning

confidence: 96%

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Gaps in Human Papillomavirus Knowledge May Serve as Barriers to Broad Anal Cytology Testing Uptake in At-Risk Women

McNeil

Levy

2021

J Low Genit Tract Dis

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confidence: 91%

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confidence: 96%

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Gaps in Human Papillomavirus Knowledge May Serve as Barriers to Broad Anal Cytology Testing Uptake in At-Risk Women

McNeil

Levy

2021

J Low Genit Tract Dis

Self Cite

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“…A crossover study from 2016 with women with HIV showed that the patients found self-performed tests to be feasible, and patients have found the practice highly acceptable [ 8 ]. In addition, the quality of samples has been found comparable to that of physician-collected specimens (PCS) [ 9 ]. A cross-sectional study with HIV-negative women performed in Puerto Rico in 2012 showed that even though most women preferred having a clinician collect anal samples (61%), the acceptability of both sampling methods (self-collected vs. clinician-collected) was high [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Adequacy and Acceptability of the Self-Collected Anal Pap Smear in People Living With Human Immunodeficiency Virus in the Infectious Diseases Clinic

Villa-Chan,

Wark,

Kubat

et al. 2024

Cureus

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Background Anal Pap smears are imperative to screening for human papillomavirus (HPV)-associated anal squamous cell cancers, particularly in patients living with human immunodeficiency virus (HIV) given a higher incidence of disease. Self-collection of specimens may be favored by patients and more feasible to collect, increasing screening. Methods This was a single-center observational cohort study at a single academic medical center Infectious Diseases clinic from October to December 2021. We aimed to improve compliance of anal Pap collection documentation of “self-collected” versus “physician-collected” as well as verify if self-collected specimens (SCS) were adequate for interpretation equivalent to physician-collected specimens (PCS). Additionally, we aimed to evaluate patient and provider satisfaction with self-collected anal Paps. Results Sixty anal Pap smears were available for evaluation. The rate of documentation of the collection method (self-collected vs. physician-collected) was 88% during the intervention. A total of 75% of patients opted for self-collection, and 35/45 (78%) of these samples were adequate for interpretation. There was no difference in the adequacy of specimen (the ability of a cytopathologist to interpret the specimen) between the SCS and PCS. Conclusion Limited prior data suggest self-collected anal Pap specimens are adequate for interpretation only slightly less often than PCS. In our small cohort, there was no statistically significant difference between collection methods. Satisfaction with self-collection of specimens was high for both patients and providers. Additional validation in more diverse/larger clinical settings may be helpful to support this practice.

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Self‐collected versus clinician‐collected anal swabs for anal cancer screening: A systematic review and meta‐analysis

Dyer,

Jin,

Hillman

et al. 2024

Intl Journal of Cancer

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Anal squamous cell carcinoma (ASCC) incidence is increasing globally. International consensus guidelines published in 2024 include HPV and/or cytology testing of anal swabs in those at greatest risk of ASCC. Self‐collected anal swabs may be important for increasing screening uptake, but evidence is needed as to their equivalence to clinician‐collected swabs. We searched Medline, Embase, Cochrane Library, and CINAHL databases for publications to 13 June 2023. Studies were included if reporting data on HPV testing, cytology testing, or acceptability, for both self‐ and clinician‐collected anal swabs. Risk of bias was assessed using the QUADAS‐2 assessment tool. The primary outcome was HPV and cytology sampling adequacy. Secondary outcomes were HPV and cytology results, and acceptability of collection methods. Thirteen papers describing 10 studies were eligible. Sample adequacy was comparable between self‐ and clinician‐collected swabs for HPV testing (meta‐adequacy ratio: 1.01 [95% CI 0.97–1.05]) but slightly lower for cytology by self‐collection (meta‐adequacy ratio: 0.91 [95% CI 0.88–0.95]). There was no significant difference in prevalence (meta‐prevalence ratio: 0.83 (95% CI 0.65–1.07) for any HR‐HPV, 0.98 (95% CI 0.84–1.14) for any HPV, and 0.68 (95% CI 0.33–1.37) for HPV16), or any cytological abnormality (meta‐prevalence ratio 1.01 [95% CI 0.86–1.18]). Only three papers reported acceptability results. Findings indicate self‐collection gives equivalent sample adequacy for HPV testing and ~ 10% inferior adequacy for cytological testing. Meta‐prevalence was similar for HPV and cytology, but confidence intervals were wide. Larger studies are required to definitively assess use of self‐collected swabs in anal cancer screening programs, including acceptability.

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Results of the Women's Self-Performed Anal Pap Trial in Human Immunodeficiency Virus–Infected Women

Cited by 8 publications

References 16 publications

Gaps in Human Papillomavirus Knowledge May Serve as Barriers to Broad Anal Cytology Testing Uptake in At-Risk Women

Gaps in Human Papillomavirus Knowledge May Serve as Barriers to Broad Anal Cytology Testing Uptake in At-Risk Women

Adequacy and Acceptability of the Self-Collected Anal Pap Smear in People Living With Human Immunodeficiency Virus in the Infectious Diseases Clinic

Self‐collected versus clinician‐collected anal swabs for anal cancer screening: A systematic review and meta‐analysis

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