Home Self-Collection by Mail to Test for Human Papillomavirus and Sexually Transmitted Infections

人乳头瘤病毒 考试(生物学) 医学 病毒学 生物 内科学 古生物学
作者
Andrea C. Des Marais,Yuqian Zhao,Marcia M. Hobbs,Vijay Sivaraman,Lynn Barclay,Noel T. Brewer,Jennifer S. Smith
出处
期刊:Obstetrics & Gynecology [Lippincott Williams & Wilkins]
卷期号:132 (6): 1412-1420 被引量:38
标识
DOI:10.1097/aog.0000000000002964
摘要

OBJECTIVE: To evaluate the validity and acceptability of at-home self-collection to test for high-risk human papillomavirus (HPV) and sexually transmitted infections among women overdue for cervical cancer screening by national guidelines. METHODS: Low-income, infrequently screened women were recruited from the general population in North Carolina to participate in an observational study. Participants provided two self-collected cervicovaginal samples (one at home and one in the clinic) and a clinician-collected cervical sample. Samples were tested for high-risk HPV, Chlamydia trachomatis , Neisseria gonorrhoeae , Trichomonas vaginalis , and Mycoplasma genitalium . Cervical samples were also tested by liquid-based cytology. RESULTS: Overall, 193 women had conclusive high-risk HPV results for all three samples and cytology results. Prevalence of high-risk HPV within self-home samples (12.4%) was not different from that within clinician samples (11.4%; P =.79) and from that within self clinic samples (15.5%; P =.21). Positivity for high-risk HPV in all sample types increased with increasing grades of cervical abnormality ( P <.001). Self-home samples detected high-risk HPV in all identified cases of high-grade squamous intraepithelial lesions and of cervical intraepithelial neoplasia 2 or worse. Detection was comparable across sample types for T vaginalis (range 10.2–10.8%), M genitalium (3.3–5.5%), C trachomatis (1.1–2.1%), and N gonorrhoeae (0–0.5%). Kappa values between sample types ranged from 0.56 to 0.66 for high-risk HPV, 0.86–0.91 for T vaginalis , and 0.65–0.83 for M genitalium . Most participants reported no difficulty understanding self-collection instructions (93.6%) and were willing to use self-collection in the future (96.3%). CONCLUSION: Mail-based, at-home self-collection for high-risk HPV and sexually transmitted infection detection was valid and well accepted among infrequently screened women in our study. These findings support the future use of high-risk HPV self-collection to increase cervical cancer screening rates among higher risk women in the United States.
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