Human papillomavirus (HPV)-based cervical screening programs (self-collected samples for HPV)

Human papillomavirus (HPV)-based cervical screening programs (self-collected samples for HPV)

• HPV positive samples are often then reflexly examined using liquid-based cytology from the same specimen
• an advantage of HPV-based testing is that it detects viral nucleic acid, rather than morphological changes in the cell, and as such there is no need to sample from the transformation zone of the cervix because viral nucleic acid is shed from the cervix into the vaginal canal
• research found that persistent infection with certain high-risk types of human papillomavirus (HPV) is responsible for more than 95% of cervical pre-cancer and cancer (2)
• self-collected samples for HPV testing (SC-HPV) have been found to be as sensitive as clinically-collected samples (3)

Using self-collection, a woman can take the sampling device, insert it into her own vagina to collect a specimen, and then return it to a healthcare provider (either directly or through the mail) without the physical intervention of a healthcare practitioner (1)

• this sample can then be processed using a nucleic acid test for the presence of HPV DNA or RNA
• at present there is not a body of evidence that supports self-collection for morphological analysis (e.g., Pap-stained cells) for the purpose of cervical screening

Reference:

• Hawkes D, Keung MHT, Huang Y, McDermott TL, Romano J, Saville M, Brotherton JML. Self-Collection for Cervical Screening Programs: From Research to Reality. Cancers (Basel). 2020 Apr 24;12(4):1053.
• Camara H, Zhang Y, Lafferty L, Vallely AJ, Guy R, Kelly-Hanku A. Self-collection for HPV-based cervical screening: a qualitative evidence meta-synthesis. BMC Public Health. 2021 Aug 4;21(1):1503.
• Arbyn M, Smith SB, Temin S, Sultana F, Castle P, Collaboration on Self-Sampling and HPV Testing. Detecting cervical precancer and reaching underscreened women by using HPV testing on self samples: updated meta-analyses. BMJ. 05 2018;363:k4823