Identification of Cervical Human Papillomavirus by Self-Collection in Grenada [OP02-6B

Abstract

INTRODUCTION: Cervical cancer and Human Papillomavirus (HPV) screening with the Papanicolaou (Pap) smear/cervical cytology is widely accessible, however, it’s underutilized in developing countries worldwide. A self-sampling device evaluated in Grenada in 2017 was determined to be acceptable to women, and adequate in obtaining and evaluating cervical cells. Additionally, testing for Human Papillomavirus (HPV), the precursor for the development of cervical cancer, was performed. METHODS: Following IRB approval, women were recruited to the St. George’s University clinic in St. George’s, Grenada. Two cervical samples were obtained from each woman: one via the self-sampling device, and one by a physician. With informed consent, 101 women provided samples, of which the first isolate was tested for the presence of HPV DNA. If HPV was identified, it was further subtyped. RESULTS: HPV was detected in 49/101 (48%) samples: 25/50 (50%) from physician obtained samples and 24/51 (47%) via the self-sampling device. The difference in detection rates was not statistically significant. A total of 24 different genotypes were detected, and classified into low-risk, high-risk or mixed. Women with abnormal results were appropriately evaluated by close follow-up, colposcopy or biopsy. CONCLUSION: The self-screening device was adequate in obtaining cervical cells with co-testing for HPV. In a group of self-referred women living in Grenada, results showed additional HPV genotypes to the usual 6, 11, 16 & 18 commonly described in the literature. Self-sampling may be an effective method of identifying HPV in a developing country, conserving limited resources for further evaluation of women at risk.