Abstract
Objective: Human papillomavirus (HPV) assays are likely to be used with increasing frequency in clinical management of women with abnormal Papanicolaou smears and in cervical cancer screening. Our objective was to simplify the method of collection of female genital tract specimens. The utility of vaginal dry swabs for HPV diagnosis was evaluated.
Methods: Specimens for cytology and for HPV identification were collected by a clinician from 189 female soldiers attending a military clinic. Three methods of specimen collection for HPV identification were compared: a vaginal dry swab (v-DRY), and vaginal and cervical swabs placed into specimen transport medium (v-STM and c-STM). Swabs were shipped to a STD laboratory for processing. Specific HPV types were identified by a consensus primer based PCR based method. Results from 165 women were evaluable.
Results: HPV prevalence by the three methods was similar and ranged from 44.8% to 50.9%. 53 (32.1%) women were HPV positive and 60 (36.4%) women were HPV negative by all three collection methods. With respect to the risk categories of specific HPV types, there was greater agreement between the results from the two vaginal (v-DRY and v-STM) samples (kappa values of 0.69–0.81) than between the cervical (c-STM) and either of the vaginal samples (kappa values of 0.37–0.55). The HPV yield from c-STM was somewhat greater than that from the vaginal specimens but the correlation between cytological abnormalities and HPV was high for all three methods.
Conclusion: A dry vaginal swab may be an acceptable method of specimen collection for HPV diagnosis.
Key Words: human papillomaviruses; diagnostic assays; dry swabs
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Selected References
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- Cuzick J., Sasieni P., Davies P., Adams J., Normand C., Frater A., van Ballegooijen M., van den Akker E. A systematic review of the role of human papillomavirus testing within a cervical screening programme. Health Technol Assess. 1999;3(14):i-iv, 1-196. [PubMed] [Google Scholar]
- Daniel R. W., Ahdieh L., Hayden D., Cu-Uvin S., Shah K. V. Intra-laboratory reproducibility of human papillomavirus identification in cervical specimens by a polymerase chain reaction-based assay. J Clin Virol. 2000 Dec;19(3):187–193. doi: 10.1016/s1386-6532(00)00142-6. [DOI] [PubMed] [Google Scholar]
- Hildesheim A., Schiffman M. H., Gravitt P. E., Glass A. G., Greer C. E., Zhang T., Scott D. R., Rush B. B., Lawler P., Sherman M. E. Persistence of type-specific human papillomavirus infection among cytologically normal women. J Infect Dis. 1994 Feb;169(2):235–240. doi: 10.1093/infdis/169.2.235. [DOI] [PubMed] [Google Scholar]
- Landis J. R., Koch G. G. The measurement of observer agreement for categorical data. Biometrics. 1977 Mar;33(1):159–174. [PubMed] [Google Scholar]
- Morrison E. A., Goldberg G. L., Hagan R. J., Kadish A. S., Burk R. D. Self-administered home cervicovaginal lavage: a novel tool for the clinical-epidemiologic investigation of genital human papillomavirus infections. Am J Obstet Gynecol. 1992 Jul;167(1):104–107. doi: 10.1016/s0002-9378(11)91637-8. [DOI] [PubMed] [Google Scholar]
- Moscicki A. B. Comparison between methods for human papillomavirus DNA testing: a model for self-testing in young women. J Infect Dis. 1993 Mar;167(3):723–725. doi: 10.1093/infdis/167.3.723. [DOI] [PubMed] [Google Scholar]
- Schiffman M. H., Bauer H. M., Hoover R. N., Glass A. G., Cadell D. M., Rush B. B., Scott D. R., Sherman M. E., Kurman R. J., Wacholder S. Epidemiologic evidence showing that human papillomavirus infection causes most cervical intraepithelial neoplasia. J Natl Cancer Inst. 1993 Jun 16;85(12):958–964. doi: 10.1093/jnci/85.12.958. [DOI] [PubMed] [Google Scholar]
- Sellors J. W., Lorincz A. T., Mahony J. B., Mielzynska I., Lytwyn A., Roth P., Howard M., Chong S., Daya D., Chapman W. Comparison of self-collected vaginal, vulvar and urine samples with physician-collected cervical samples for human papillomavirus testing to detect high-grade squamous intraepithelial lesions. CMAJ. 2000 Sep 5;163(5):513–518. [PMC free article] [PubMed] [Google Scholar]
- Thomas K. K., Hughes J. P., Kuypers J. M., Kiviat N. B., Lee S. K., Adam D. E., Koutsky L. A. Concurrent and sequential acquisition of different genital human papillomavirus types. J Infect Dis. 2000 Sep 5;182(4):1097–1102. doi: 10.1086/315805. [DOI] [PubMed] [Google Scholar]
- Walboomers J. M., Jacobs M. V., Manos M. M., Bosch F. X., Kummer J. A., Shah K. V., Snijders P. J., Peto J., Meijer C. J., Muñoz N. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol. 1999 Sep;189(1):12–19. doi: 10.1002/(SICI)1096-9896(199909)189:1<12::AID-PATH431>3.0.CO;2-F. [DOI] [PubMed] [Google Scholar]
- Wright T. C., Jr, Denny L., Kuhn L., Pollack A., Lorincz A. HPV DNA testing of self-collected vaginal samples compared with cytologic screening to detect cervical cancer. JAMA. 2000 Jan 5;283(1):81–86. doi: 10.1001/jama.283.1.81. [DOI] [PubMed] [Google Scholar]
- Wright T. C., Jr, Denny L., Kuhn L., Pollack A., Lorincz A. HPV DNA testing of self-collected vaginal samples compared with cytologic screening to detect cervical cancer. JAMA. 2000 Jan 5;283(1):81–86. doi: 10.1001/jama.283.1.81. [DOI] [PubMed] [Google Scholar]