High-risk and low-risk human papillomavirus detection in self-collected samples compared to clinician-collected...

Persistent infections with human papillomavirus (HPV) cause approximately 95% of cervical cancers. The introduction of cytology screening has, however, significantly reduced morbidity and mortality rates. More recently, HPV DNA testing has been shown to be more sensitive than traditional cytology-based testing in detecting cervical intraepithelial neoplasia (CIN) grade 2 or worse (CIN2+). Self-sampling for HPV testing offers a viable alternative to clinician-performed sampling and could potentially increase participation rates in organized screening programs. Here, we compared the accuracy of self-collected vaginal samples with clinical-collected cervical samples for HPV-based screening and evaluated the acceptability of HPV self-sampling among Polish women.

Women with unclear or abnormal results at their last cytology screening were invited to participate. Each participant submitted two swabs for HPV testing: one clinical-collected cervical swab and one self-collected vaginal swab (Evalyn^® Brush). Both sample types were subsequently tested with the EUROArray HPV assay. Participants also completed a questionnaire to assess their experiences with the self-sampling procedure and express their opinions on it.

In total, 180 women aged 30 to 70 years were recruited. The prevalence of high-risk (hr) HPV was 56.7% in clinician-collected samples and 55.0% in self-collected samples. Overall concordance for any HPV, hr-HPV and low-risk (lr) HPV detection between self-collected and clinician-collected samples was 88.9%, 86.1%, and 85.0%, respectively. Most participants found self-sampling comfortable (82.4%), useful (87.0%), and convenient (85.8%) and felt low/very low stress (58.0%) while sampling. In total, 81.3% of the women reported that it was practically painless and 77.2% felt less embarrassed. Of the respondents, 51.1% preferred clinician-collected sampling, 40.9% preferred self-sampling, while 4.6% had no preference.

Vaginal self-sampling using the Evalyn^® Brush showed substantial agreement with cervical clinician-sampling for HPV detection using the EUROArray HPV test. Self-sampling for HPV testing was well-accepted by the participants. It represents a feasible alternative for clinical sampling in Poland, which could be effectively integrated into the national HPV screening program.