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Human papillomavirus detection in self‐collected vaginal specimens and matched clinician‐collected cervical specimens

KHANNA, N.*,†,‡; MISHRA, S. I.†,§,‖; TIAN, G.¶; TAN, M. T.¶; ARNOLD, S.*; LEE, C.†,#; RAMACHANDRAN, S.**; BELL, L.**; BAQUET, C. R.†,‡,§,‖,#,††; LORINCZ, A.**

International Journal of Gynecological Cancer: May/June 2007 - Volume 17 - Issue 3 - p 615–622
Original Article

Human papillomavirus (HPV) detection is an integral part of cervical cancer screening, and a range of specimen collection procedures are being tested. Preliminary studies have found that the majority of women prefer self-collection of vaginal specimens instead of clinician-collected specimens of the cervix. The purposes of the current study were to explore the social and behavioral predictors of acceptance of self-collection of vaginal specimens among patients and to assess concordance in detection of HPV between clinician-collected cervical specimens and self-collected vaginal specimens. The study was conducted at a university family medicine clinic using a cross-sectional study design, and enrollment of women presenting for routine gynecological examination consecutively in a period of 1 year, self-administered questionnaires, collection of paired vaginal and cervical specimens for HPV DNA using Hybrid Capture 2, and cytologic analysis. Most women (79.8% [398/499]) agreed to collect vaginal specimens. In our study, 76.6% (216/282) African American women (AA), 88.1% (156/176) white non-Hispanic (WNH) women, and 63.4% (26/41) women of other races (P < 0.0001) agreed to self-collect vaginal specimens. HPV was detected in 16.0% (80/499) of clinician-collected cervical specimens and 26.1% (104/398) of self-collected vaginal specimens (P < 0.001). HPV detection was concordant in 13.4% (53/398) women in both cervical and vaginal specimens. Self-collection of vaginal specimens for HPV DNA detection is acceptable to most women presenting for routine gynecological examination. WNH women were more likely to obtain self-collected specimens than AA women. Vaginal specimens were more likely to be positive for HPV than were cervical specimens.

*Department of Family Medicine, Greenebaum Cancer Center, University of Maryland, Baltimore, Maryland

†School of Medicine, Greenebaum Cancer Center, University of Maryland, Baltimore, Maryland

‡Greenebaum Cancer Center, University of Maryland, Baltimore, Maryland

§Department of Epidemiology and Prevention Medicine, Greenebaum Cancer Center, University of Maryland, Baltimore, Maryland

‖Office of Research Policy and Planning, Greenebaum Cancer Center, University of Maryland, Baltimore, Maryland

¶Information Technology and Biostatistics Division, Greenebaum Cancer Center, University of Maryland, Baltimore, Maryland

#Department of Internal Medicine, University of Maryland, Baltimore, Maryland

**Research and Development, Digene Corporation, Gaithersburg, Maryl

††Department of Medicine, University of Maryland, Baltimore, Maryland

Address correspondence and reprint requests to: Niharika Khanna, MD, University of Maryland School of Medicine, 29 South Paca Street, Baltimore, MD 21201, USA. Email: nkhanna@som.umaryland.edu

Prior presentations: The results were presented in part at the annual conference of the European Research Organization on Genital Infection and Neoplasm (EUROGIN), April 13–16, 2003, Paris, France, and at the annual conference of the North American Primary Care Research Group, October 25–28, 2003, Banff, Canada.

Accepted for publication October 5, 2006

Copyright © 2007 Blackwell Publishing Ltd.