The effectiveness and acceptability of screening for human papillomavirus in self- and medical sampling of vaginal discharge
Objective. To evaluate the effectiveness and acceptability of screening for high-risk (HR) human papillomavirus (HPV) (HR-HPV) during self-sampling and medical sampling of vaginal discharge. Subjects and methods. A cross-sectional study was conducted in 200 women aged 18-45 years (mean age, 32.7±6.9 years) who had visited a polyclinic for admission to work. Vaginal discharge was sampled for HR-HPV by a polymerase chain reaction (PCR) assay twice: independently using a Qvintip device and by a doctor from the cervical canal. The acceptability of self-sampling was estimated using a 5-point Likert scale according to the results of a survey of patients about their comfort, tenderness, confidentiality, and confusion when material had been collected for PCR study. The generalized acceptability indicator was calculated from the sum of individual Likert scale scores. Results. HR-HPV was detected in 42% of the surveyed. The effectiveness of the survey using the Qvintip device was higher than that of medical sampling: 38% vs 27.5% (OR = 1.6; 95% CI, 0.48-2.45). The use of the Qvintip device only increased a chance to detect HR-HPV by 5 times (36.3% vs 9.5%, OR=5.0; 95% CI, 1.61–6.71). The detection rate for HPV type 16 was the highest (17.7%); the less common HPV types were 56 (16.3%), 39 (13.6%), 31 (10.9%), 33 (8.2%), 51 (8.2%), 58 (7.5%), 52 (6.1%), 45 (5.4%), 18 (4.1%), 35 (1.4%), and 59 (0.7%). Several types of HR-HPV were identified in 51.2% of the HPV-positive women. The patients showed high compliance to self-sampling for HPV tests with the Qvintip device. 64% of the patients expressed a preference for self-sampling the material for HPV test; 36% did for medical sampling (p<0.001). The main reasons why the patients had chosen self-sampling were ascertained to be more comfort (75% vs 22.2%; p < 0.001), lower tenderness (70.3% vs 22.2%; p < 0.001), and less confusion (25.8% vs 1.4%; p < 0.001). The only reason why medical sampling is preferred was greater confidence that the material was taken correctly (10.1% vs 84.7%; p < 0.001). 96% of the women would prefer the self-sampling of material for HPV test in future, as it is simple and does not require a visit to the doctor’s office. Conclusion. The organized reproductive-aged women have a high rate of infection with HR-HPV (42%). The Qvintip device for HPV DNA self-sampling is simple and easy-to-use, has a high diagnostic efficiency, and may be an alternative cervical cancer screening method. High patient compliance with HPV DNA self-sampling can increase the number of women participating in cervical screening programs.Belokrinitskaya T.E., Frolova N.I., Turanova O.V., Shemyakina K.N., Pletneva V.A., Sambueva N.B., Maltseva E.E.
Keywords
high-risk human papillomavirus (HPV)
HPV test
self-sampling
cervical cancer
Qvintip
Supplementary Materials
- Table 1. Medical and social characteristics of patients of the compared groups
- Table 2. Differences between acceptability scores: self-sampling versus medical sampling of vaginal discharge for HR-HPV-test (n=200)
- Table 3. Reasons for preference: self-sampling vs medical sampling (n=200)
- Fig. 1. HR-HPV type distribution including single and multiple HR-HPV infections (n=84)
- Fig. 2. HR-HPV type distribution in 84 HR-HPV-positive woman
- Fig. 3. The frequency of combinations of HR-HPV types of different phylogenetic groups
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Received 16.12.2016
Accepted 23.12.2016
About the Authors
Belokrinitskaya Tatiana Evgenevna, MD, PhD, Professor, the head of the Obstetrics and Gynecology Department, Chita State Medical Academy,Ministry of Health of Russian. 672090, Russia, Chita, Gorky str. 39a. Email: tanbell24@mail.ru
Frolova Nataly Ivanovna, Assistant of Professor, Obstetrics and Gynecology Department, Chita State Medical Academy, Ministry of Health of Russian.
672090, Russia, Chita, Gorky str. 39a. Email: taasyaa@mail.ru
Turanova Oksana Valerievna, postgraduate student of Obstetrics and Gynecology Department, Chita State Medical Academy, Ministry of Health of Russian.
672090, Russia, Chita, Gorky str. 39a. Email: pochta@chitgma.ru
Shemyakina Ksenia Nikolaevna, student, member of the Youth Scientific Society of the Obstetrics and Gynecology Department, Chita State Medical Academy,
Ministry of Health of Russian. 672090, Russia, Chita, Gorky str. 39a. Email: pochta@chitgma.ru
Pletneva Valeria Andreevna, student, member of the Youth Scientific Society of the Obstetrics and Gynecology Department, Chita State Medical Academy,
Ministry of Health of Russian. 672090, Russia, Chita 672090, Gorky str. 39a. Email: pochta@chitgma.ru
Sambueva Natalia Borisovna, student, member of the Youth Scientific Society of the Obstetrics and Gynecology Department, Chita State Medical Academy,
Ministry of Health of Russian. 672090, Russia, Chita, Gorky str. 39a. Email: pochta@chitgma.ru
Maltseva Ekaterina Evgenevna, student, member of the Youth Scientific Society of the Obstetrics and Gynecology Department, Chita State Medical Academy,
Ministry of Health of Russian. 672090, Russia, Chita, Gorky str. 39a. Email: pochta@chitgma.ru
For citations: Belokrinitskaya T.E., Frolova N.I., Turanova O.V., Shemyakina K.N., Pletneva V.A., Sambueva N.B., Maltseva E.E. The effectiveness and acceptability of screening for human papillomavirus in self- and medical sampling of vaginal discharge. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (2): 97-105. (in Russian)
http://dx.doi.org/10.18565/aig.2017.2.97-105
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