Abstract

IntroductionThe multiple visits required for an effective Pap smear screening program is difficult to replicate in many developing countries. This precludes early diagnosis and care for patients with cervical cancer and contributes to its high mortality in these countries. HPV screening has higher specificity and high negative predictive value and has the advantage that materials can be self-collected, which permits the screening of women who for various cultural and religious reasons would be reluctant to come to the clinic to expose themselves for screening. The aim of the study was to assess the degree of agreement between self sampling for HPV DNA with samples collected by a health provider.MethodsEach respondent selected from women presenting for cervical cancer screening underwent both self- and provider sampling for HPV DNA testing using Hybribio GenoArray.ResultsOf the 194 women screened, 12 (6.2%) and 19 (9.8%) had HPV on self sampling and provider col-lected samples respectively. The commonest HPV type seen using both techniques was HPV 58 (2.6%). Multiple HPV genotypes were seen in 1 (0.5%) and 5 cases (2.6%) of provider and self-collected samples respectively. The high risk-HPV detection rate was 7.2% when self sampled and 6.8% when sampled by the provider. There was moderate correlation between both sampling techniques (κ = 0.47, 95% CI: 21.3 - 72.3%, P < 0.05).ConclusionOur study shows moderate correlation between both sampling techniques. Larger multicentre studies will be needed to provide results generalisable to the Nigerian population. Keywords: Pap smear, HPV screening, cervical cancer, sample collection, self-sampling, provider collected, PCR, HPV DNA, Ile-Ife Nigeria.

Highlights

  • The multiple visits required for an effective Pap smear screening program is difficult to replicate in many developing countries

  • All HPV types seen on provider collected samples were high-risk types, giving a high risk HPV detection rate of 6.2%

  • Fourteen high-risk HPV types were seen on self sampling, giving a high-risk HPV detection rate of 7.2%

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Summary

Introduction

The multiple visits required for an effective Pap smear screening program is difficult to replicate in many developing countries This precludes early diagnosis and care for patients with cervical cancer and contributes to its high mortality in these countries. The aim of the study was to assess the degree of agreement between self sampling for HPV DNA with samples collected by a health provider. Over the past 30 years the incidence and mortality rates have declined in developed countries This is largely due to effective and efficient cervical cancer screening programs using pap smears and HPV DNA testing [1]. Barriers to screening in developing countries include competing health needs, limited human and financial re-sources, poorly developed healthcare services, disempowerment of women, widespread poverty, war and civil strife [3].

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