Abstract
BackgroundCervical cancer incidence and mortality rates in Bolivia are among the highest in Latin America. This investigation aims to evaluate the possibility of using simple devices, e.g. a cotton swab and a glass slide, for self-sampling in order to detect human papillomavirus (HPV) DNA by PCR in cervico-vaginal cells.MethodsIn the first phase of our study we evaluated the use of a glass slide as a transport medium for cervical cells. A physician took paired-cervical samples from 235 women. One sample was transported in Easyfix® solution and the other sample was smeared over a glass slide. Both were further analyzed and compared for human DNA recovery and HPV detection. A kappa value was determined to evaluate the agreement between the HPV DNA detection rates.In the second phase of the study, 222 women from the urban, peri-urban and rural regions of Cochabamba were requested to perform self-sampling using the following devices: a cotton swab combined with a glass slide, and a vaginal tampon. Women gave their opinion about the self-sampling technique.Finally, the agreement for high risk-HPV detection between self- and physician-collected samples was performed in 201 samples in order to evaluate the self-sampling technique.ResultsFirstly, the comparison between Easyfix® solution and the glass slide to transport clinical samples gave a good agreement for HPV DNA detection (κ = 0.71, 95% CI 0.60–0.81). Secondly, self-sampling, especially with cotton swab combined with glass slide, would generally be preferred over clinician sampling for a screening program based on HPV detection. Finally, we showed a good agreement between self- and physician collected samples for high risk-HPV detection (κ = 0.71, 95% CI 0.55–0.88).ConclusionsSimple devices such as a cotton swab and a glass slide can be used to perform self-sampling and HPV DNA detection. Furthermore, most Bolivian women preferred self-sampling over clinician-sampling for cervical cancer screening.
Highlights
Cervical cancer incidence and mortality rates in Bolivia are among the highest in Latin America
Evaluation of a glass slide as transport medium for cervico-vaginal samples To evaluate the possibility of using a glass slide to transport cervical cells samples for human papillomavirus (HPV) Deoxyribonucleotide acid (DNA) detection through Polymerase chain reaction (PCR), we recruited 235 women with cytological abnormalities and compared human β-globin and HPV PCR results from their samples
Comparison of HPV detection rates obtained for the samples with positive β-globin PCR (207 cases) showed a good level of concordance (κ = 0.71, 95% CI 0.60–0.81, Table 1)
Summary
Cervical cancer incidence and mortality rates in Bolivia are among the highest in Latin America. The incidence and mortality rates of cervical cancer in Bolivia are the highest in Latin America: 39.5 and 16.5 per 100,000 women, respectively [1]. This is noteworthy as cervical cancer can be prevented by opportune screening and treatment of precancerous lesions. 50% to 80% of screened women are lost during follow-up and the lowest coverage rates are observed in the lowest-income population who are at highest risk for cervical cancer [4].
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