Pilot Study for the Utilization of Self-sampling Devices for HPV Testing in Cervical Cancer Screening.

Introduction

Cervical cancer is the third most common cancer in women worldwide. While screening program is available, only about 55% of women between 25 and 69 attend the screening program in the Czech Republic. Sending of call letters has increased screening attendance only by 8%. Another possibility how to improve screening attendance could be an offer of self-sampling kits to non-attenders. The aim of this study is to get initial experience with alternative sampling (self-sampling) for HPV testing as the means of cervical cancer screening program.

Materials/methods

Based on expression of interest, 215 self-sampling kits were sent by post to women. EvalynR Brush (Rovers Medical) cervicovaginal swabs obtained by self-sampling were analyzed for the presence of HPV infection by Cobas 4800 HPV (Roche) followed by genotyping using PapilloCheckR HPVScreening (Greiner Bio-One). Sixty women randomly chosen from our sample set were sent a questionnaire focused on their experience with self-sampling.

Results and conclusions

One hundred seventy-four of 215 (81%) distributed self-sampling devices have been delivered to analysis. All cervicovaginal swabs were sampled correctly and it was possible to analyze them by Cobas 4800 HPV test. Similarly, 98% (171/174) samples were analyzable by PapilloCheckR HPV-Screening. One hundred twenty-five (72%) of 174 tested samples were HPV negative. Low risk HPV infection was detected only in 7 samples (4%), and high risk HPV (hrHPV) infection was present in 42 samples (24%). The most frequently detected hrHPV genotypes were HPV16 (11/42; 26%) and HPV53 (6/42; 14%). HrHPV coinfection was detected in 10 cases, in 5 of them lrHPV infection was found as well. Of the 60 questionnaires, 48 (80%) were returned. Women found selfsampling convenient and most of them (n = 42 [88%]) preferred selfsampling to physician sampling. Cervicovaginal self-sampling leads to valid results of HPV detection using two molecular genetics methods and was accepted by the Czech women very well. The self-sampling as an opportunity to participate in cervical cancer screening could potentially increase the attendance of the screening program and would help to reduce the incidence and mortality for this disease in the Czech population.

Study funding: IGA_LF_2015_010, CZ.1.05/3.1.00/14.0307. Authors claim no conflict of interests