Experience with high-risk human papillomavirus testing on vaginal brush-based self-samples of non-attendees of the cervical screening program.
Gok, Murat 1; van Kemenade, Folkert J. 1; Heideman, Danielle A.M. 1; Berkhof, Johannes 2; Rozendaal, Lawrence 1; Spruyt, Johan W.M. 3; Belien, Jeroen A.M. 1; Babovic, Milena 4; Snijders, Peter J.F. 1; Meijer, Chris J.L.M. 1
[Miscellaneous Article]
International Journal Of Cancer.
130(5):1128-1135, March 1, 2012.
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: We evaluated the effect of offering brush-based vaginal self-sampling for high-risk human papillomavirus (hrHPV) testing to non-attendees of the cervical screening program on response rate, compliance to follow-up and cervical intraepithelial neoplasia grade 2 or 3 (CIN2 /CIN3 ) yield. In addition, concordance of hrHPV test results between physician-taken cervical scrapes and vaginal self-samples was determined. A total of 26,409 nonattending women were randomly assigned to receive a vaginal brush device for hrHPV testing by Hybrid Capture-2(R) method (i.e.,self-sampling group,n= 26,145) or a reinvitation for regular cytology-based screening (i.e.,recall control group,n= 264). hrHPV-positive self-sampling responders were invited for a physician-taken scrape for cytology and blinded hrHPV testing. If cytology was abnormal, women were referred for colposcopy. Response rate in the self-sampling group was significantly increased compared to the recall control group (30.8%versus6.5%;p< 0.001). The concordance rate between hrHPV detection in self-samples and corresponding physician-taken cervical scrape samples was 68.8%. Amongst women with CIN3 and CIN2 , the concordance rates in hrHPV positivity between both samples were 95.5% and 93.8%, respectively. Adherence at baseline to cytology triage of hrHPV-positive self-sampling women (89.1%) and colposcopy referral of those with abnormal cytology (95.8%) was high. The CIN2 /CIN3 /carcinoma yields were 1.5%, 1.0% and 0.1%, respectively, in self-sampling responders. In conclusion, offering hrHPV testing on self-sampled vaginal material with a brush device to non-attendees significantly increases the attendance to the regular screening program, yields hrHPV test results that are in very good concordance with those of physician-taken scrapes in women with CIN2 /CIN3 , and is effective in detecting CIN2 /CIN3 .
Copyright (C) 2012 John Wiley & Sons, Inc.