self- versus physician-collected samples for the follow-up of human papillomavirus-positive women in sub-saharan africa

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ID: 146432
2018
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Abstract
Manuela Viviano,1,* Phuong Lien Tran,1,* Bruno Kenfack,2 Rosa Catarino,1 Mohamed Akaaboune,1,† Liliane Temogne,2 Eveline Tincho Foguem,2 Pierre Vassilakos,3 Patrick Petignat1 1Gynecology Division, Geneva University Hospitals, Geneva, Switzerland; 2Department of Biomedical Sciences, University of Dschang, Dschang, Cameroon; 3Geneva Foundation for Medical Education and Research, Geneva, Switzerland *These authors contributed equally to the work †MA passed away on July 31, 2017 Introduction: Human papillomavirus (HPV) testing is a suitable tool for primary cervical cancer (CC) screening and follow-up in low-resource settings. Vaginal samples taken by women themselves (Self-HPV) are an interesting alternative to physician-performed sampling (Dr-HPV). Our aim was to assess the performance of Self-HPV and Dr-HPV at 6 and 12 months following a CC screening campaign. Methods: This study was carried out at the Dschang District Hospital, Cameroon. Women aged 30–49 years were recruited in a CC screening campaign. HPV-positive women, of whom 2/3 were treated with thermoablation because of abnormal results at baseline screening, were invited to participate in a follow-up study. Self- and Dr-HPV, as well as cytology, were performed at 6 and 12 months. HPV samples were analyzed using the Xpert HPV assay. Sensitivity and specificity for the detection of low-grade squamous intraepithelial lesion or worse and of high-grade squamous intraepithelial lesion or worse were calculated for Self-HPV and Dr-HPV, using cytology as the reference diagnosis. Results: Overall, 188 HPV-positive women were invited to attend follow-up. The obtained follow-up visits’ attendance was 154 (81.9%) and 131 (69.7%) at 6 and 12 months, respectively. While the overall performance of Dr-HPV at 6 months was slightly superior, Self-HPV showed an improved sensitivity for HSIL+ detection at 12 months when compared with Dr-HPV (83.3% [95% CI 41.8–98.9] versus 71.4% [95% CI 21.5–95.8], respectively). The overall HPV positivity agreement between Self- and Dr-HPV at 6 and 12 months corresponded to a κ value of 0.62 and 0.52, respectively. Among women treated with thermoablation (n=121) at baseline screening, Self-HPV was as sensitive as Dr-HPV, although less specific (P=0.003). Conclusion: Self-HPV is a valuable tool for the follow-up of HPV-positive women in low-resource settings. Larger, randomized trials are needed to confirm the validity of our findings. Keywords: human papillomavirus testing, self-sampling, cervical cancer, screening, follow-up
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m2018internationalself- Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Viviano M, Tran PL, Kenfack B, Catarino R, Akaaboune M, Temogne L, Tincho Foguem E, Vassilakos P, Petignat P
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Journal journal of advanced oxidation technologies
Year 2018
DOI
DOI not found
URL
https://www.dovepress.com/self-versus-physician-collected-samples-for-the-follow-up-of-human-pap-peer-reviewed-article-IJWH
Keywords
Screening gynecology and obstetrics cervical cancer follow-up self-sampling

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