Agreement between self- and clinician-collected specimen results for detection and typing of high-risk human papillomavirus in specimens from women in Gugulethu, South Africa
We assessed the agreement in detection of high-risk human papillomavirus (HPV), as well as specific HPV types, between self- and clinician-obtained specimens for 450 women over 18 years of age attending a community health center in Gugulethu, South Africa. Both self-collected swabs and tampons had high agreement with clinician-obtained brushes when the Roche Reverse Line Blot Assay (RLBA) was used (for swabs, 86% concordance, with a kappa statistic [κ] of 0.71; for tampons, 89% concordance, with K of 0.75). Agreement was lower, although still fair, with the Digene Hybrid Capture 2 test (HC2), with K higher for swabs than for tampons (for swabs, 81% concordance, with K of 0.61; for tampons, 82% concordance, with κ of 0.55). Low-risk HPV types were nearly two times more common in self-collected specimens than in clinician-collected specimens tested by RLBA. All 15 women diagnosed with high-grade lesions by cytology tested positive for high-risk HPV with clinician-collected specimens tested by RLBA and HC2, while 11 out of 15 tested positive with self-collected specimens by HC2 and 5 out of 6 tested positive by RLBA. Self-collected specimens can provide valid specimens for HPV testing using nucleic acid amplification tests, although a few cytological abnormalities may be missed.
Jones, Heidi E., Bruce R. Allan, Janneke van de Wijgert, Lydia Altini, Sylvia M. Taylor, Alana de Kock, Nicol Coetzee, and Anna Lise Williamson. 2007. "Agreement between self- and clinician-collected specimen results for detection and typing of high-risk human papillomavirus in specimens from women in Gugulethu, South Africa," Journal of Clinical Microbiology 45(6): 1679–1683.