Cervical cancer screening: Impact of collection technique on human papillomavirus detection and genotyping
Background: The Food and Drug Administration (FDA) in the US approved primary human papillomavirus (HPV) testing for speculum-based cervical cancer screening ten years ago and, in May 2024, approved the self-collection technique. Our study defines the kappa agreement between self- and speculum-based...
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Elsevier
2025-02-01
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| Series: | Preventive Medicine Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2211335525000105 |
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| author | Alisa P. Young Mutiya Olorunfemi Leigh Morrison Scott A. Kelley Anna Laurie Anna McEvoy Jill Schneiderhan Julie Prussack Marie Claire O'Dwyer Pamela Rockwell Philip Zazove Jonathan Gabison Jane Chargot Kristina Gallagher Ananda Sen Dongru Chen Elizabeth A. Haro Emma A. Butcher Martha L. Alves Christelle El Khoury Melinda L. Dendrinos Nicole Brashear Roger Smith Richard W. Lieberman Natalie Saunders Elizabeth Campbell Heather M. Walline Diane M. Harper |
| author_facet | Alisa P. Young Mutiya Olorunfemi Leigh Morrison Scott A. Kelley Anna Laurie Anna McEvoy Jill Schneiderhan Julie Prussack Marie Claire O'Dwyer Pamela Rockwell Philip Zazove Jonathan Gabison Jane Chargot Kristina Gallagher Ananda Sen Dongru Chen Elizabeth A. Haro Emma A. Butcher Martha L. Alves Christelle El Khoury Melinda L. Dendrinos Nicole Brashear Roger Smith Richard W. Lieberman Natalie Saunders Elizabeth Campbell Heather M. Walline Diane M. Harper |
| author_sort | Alisa P. Young |
| collection | DOAJ |
| description | Background: The Food and Drug Administration (FDA) in the US approved primary human papillomavirus (HPV) testing for speculum-based cervical cancer screening ten years ago and, in May 2024, approved the self-collection technique. Our study defines the kappa agreement between self- and speculum-based collection techniques for 15 types of high-risk HPV. Additionally, we describe the sensitivity and specificity ratios for HPV testing using both collection methods. Methods: Participants recruited in 2020–2022 included 97 colposcopy attendees and 96 routine primary care screening attendees aged 30–65, who agreed to self-sample before their clinically scheduled speculum-based exam. Prevalence-based kappa calculated agreement, sensitivity and specificity ratios calculated accuracy using the cervical intraepithelial neoplasia grade 2 or worse (CIN 2+) threshold. Results: The average ages were 45.9 (SD 10.5) and 46.2 (SD 11.0) years for the colposcopy and primary care attendees, respectively. HPV 16, 68, and 39 were the most common types detected. The lower bound of the 95 % Cl for kappa calculations was above 0.81, indicating almost perfect agreement across all HPV genotypes. The sensitivity and specificity ratios were consistent at 1.0 across both collection methods. The HPV positivity rate was significantly higher among colposcopy attendees at 66 % (64/97), compared to 14 % (13/96) among routine primary care screeners. The study identified 17 women with CIN2 + . Conclusions: Primary HPV screening with self-collection is equivalent to speculum-based collection among people aged 30–65. The findings emphasize the utility of self-collection in identifying high-grade lesions and the consistency of HPV detection across different collection methods. |
| format | Article |
| id | doaj-art-441df925dd5846e789e1c18c6d4a8b0b |
| institution | Kabale University |
| issn | 2211-3355 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Preventive Medicine Reports |
| spelling | doaj-art-441df925dd5846e789e1c18c6d4a8b0b2025-02-08T05:00:15ZengElsevierPreventive Medicine Reports2211-33552025-02-0150102971Cervical cancer screening: Impact of collection technique on human papillomavirus detection and genotypingAlisa P. Young0Mutiya Olorunfemi1Leigh Morrison2Scott A. Kelley3Anna Laurie4Anna McEvoy5Jill Schneiderhan6Julie Prussack7Marie Claire O'Dwyer8Pamela Rockwell9Philip Zazove10Jonathan Gabison11Jane Chargot12Kristina Gallagher13Ananda Sen14Dongru Chen15Elizabeth A. Haro16Emma A. Butcher17Martha L. Alves18Christelle El Khoury19Melinda L. Dendrinos20Nicole Brashear21Roger Smith22Richard W. Lieberman23Natalie Saunders24Elizabeth Campbell25Heather M. Walline26Diane M. Harper27Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USADepartment of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USADepartment of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USADepartment of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USADepartment of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USADepartment of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USADepartment of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USADepartment of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USADepartment of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USADepartment of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USADepartment of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USADepartment of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USADepartment of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USADepartment of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USADepartment of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA; Department of Biostatistics, School of Public Health, 1415 Washington Heights, University of Michigan, Ann Arbor, MI 48109, USADepartment of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USADepartment of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USADepartment of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USADepartment of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USADepartment of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USADepartment of Obstetrics and Gynecology, 1500 E Medical Center Dr # 9, University of Michigan Medical School, Ann Arbor, MI 48109, USADepartment of Obstetrics and Gynecology, 1500 E Medical Center Dr # 9, University of Michigan Medical School, Ann Arbor, MI 48109, USADepartment of Obstetrics and Gynecology, 1500 E Medical Center Dr # 9, University of Michigan Medical School, Ann Arbor, MI 48109, USADepartment of Obstetrics and Gynecology, 1500 E Medical Center Dr # 9, University of Michigan Medical School, Ann Arbor, MI 48109, USADepartment of Obstetrics and Gynecology, 1500 E Medical Center Dr # 9, University of Michigan Medical School, Ann Arbor, MI 48109, USADepartment of Obstetrics and Gynecology, 1500 E Medical Center Dr # 9, University of Michigan Medical School, Ann Arbor, MI 48109, USADepartment of Otolaryngology, 1500 E Medical Center Dr # 1 University of Michigan Medical School, Ann Arbor, MI 48109, USADepartment of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA; Department of Obstetrics and Gynecology, 1500 E Medical Center Dr # 9, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Corresponding author at: 1018 Fuller Street, Ann Arbor, MI 48105, USA.Background: The Food and Drug Administration (FDA) in the US approved primary human papillomavirus (HPV) testing for speculum-based cervical cancer screening ten years ago and, in May 2024, approved the self-collection technique. Our study defines the kappa agreement between self- and speculum-based collection techniques for 15 types of high-risk HPV. Additionally, we describe the sensitivity and specificity ratios for HPV testing using both collection methods. Methods: Participants recruited in 2020–2022 included 97 colposcopy attendees and 96 routine primary care screening attendees aged 30–65, who agreed to self-sample before their clinically scheduled speculum-based exam. Prevalence-based kappa calculated agreement, sensitivity and specificity ratios calculated accuracy using the cervical intraepithelial neoplasia grade 2 or worse (CIN 2+) threshold. Results: The average ages were 45.9 (SD 10.5) and 46.2 (SD 11.0) years for the colposcopy and primary care attendees, respectively. HPV 16, 68, and 39 were the most common types detected. The lower bound of the 95 % Cl for kappa calculations was above 0.81, indicating almost perfect agreement across all HPV genotypes. The sensitivity and specificity ratios were consistent at 1.0 across both collection methods. The HPV positivity rate was significantly higher among colposcopy attendees at 66 % (64/97), compared to 14 % (13/96) among routine primary care screeners. The study identified 17 women with CIN2 + . Conclusions: Primary HPV screening with self-collection is equivalent to speculum-based collection among people aged 30–65. The findings emphasize the utility of self-collection in identifying high-grade lesions and the consistency of HPV detection across different collection methods.http://www.sciencedirect.com/science/article/pii/S2211335525000105Cervical cancer screeningSelf-sampling.Primary HPV screening.Agreement.Kappa.Sensitivity. |
| spellingShingle | Alisa P. Young Mutiya Olorunfemi Leigh Morrison Scott A. Kelley Anna Laurie Anna McEvoy Jill Schneiderhan Julie Prussack Marie Claire O'Dwyer Pamela Rockwell Philip Zazove Jonathan Gabison Jane Chargot Kristina Gallagher Ananda Sen Dongru Chen Elizabeth A. Haro Emma A. Butcher Martha L. Alves Christelle El Khoury Melinda L. Dendrinos Nicole Brashear Roger Smith Richard W. Lieberman Natalie Saunders Elizabeth Campbell Heather M. Walline Diane M. Harper Cervical cancer screening: Impact of collection technique on human papillomavirus detection and genotyping Preventive Medicine Reports Cervical cancer screening Self-sampling. Primary HPV screening. Agreement. Kappa. Sensitivity. |
| title | Cervical cancer screening: Impact of collection technique on human papillomavirus detection and genotyping |
| title_full | Cervical cancer screening: Impact of collection technique on human papillomavirus detection and genotyping |
| title_fullStr | Cervical cancer screening: Impact of collection technique on human papillomavirus detection and genotyping |
| title_full_unstemmed | Cervical cancer screening: Impact of collection technique on human papillomavirus detection and genotyping |
| title_short | Cervical cancer screening: Impact of collection technique on human papillomavirus detection and genotyping |
| title_sort | cervical cancer screening impact of collection technique on human papillomavirus detection and genotyping |
| topic | Cervical cancer screening Self-sampling. Primary HPV screening. Agreement. Kappa. Sensitivity. |
| url | http://www.sciencedirect.com/science/article/pii/S2211335525000105 |
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