Human Papillomavirus Infection in Women Who Submit Self-collected Vaginal Swabs After Internet Recruitment

Abstract

Submission of vaginal samples collected at home could remove barriers that women face in getting screened for cervical cancer. From December 2013 to January 2014, women aged 21-30 years were recruited online to participate in either (1) self-collected testing for human papillomavirus (HPV) infection and an online survey, or (2) an online survey regarding their perceptions of self-collected testing for HPV infection. Demographics, risk factors, testing perceptions, and satisfaction with self-collected testing were assessed with online questionnaires. Women who performed self-collection were sent a home sampling kit by US mail, which was returned via US mail for HPV testing. A total of 197 women were enrolled, with 130 completing the online survey and 67 participating in both the survey and self-collection. Of the 67 women who were sent kits, 62 (92.5%) were returned for testing. Sixty kits contained a sample sufficient for testing. The overall prevalence of HPV infection was 17.8%, however 6 women (9.7%) were infected with >1 type of HPV. Women who self-collected a sample reported more favorable attributes of self-collection compared to women who only participated in the online survey, including ease of sampling (87.1 vs. 18.9%), no pain during sampling (72.6 vs. 5.6%), and lack of embarrassment (67.7 vs. 12.9%). A high prevalence of HPV infection was demonstrated among women recruited via the internet. Online recruitment and at home screening methods have the potential to engage women in screening by offering an approach that might be more acceptable to women of different backgrounds.

Perspectives from health-care providers and women about completing human papillomavirus (HPV) self-testing at home

“…The findings from the current study are similar to prior studies conducted among women living in other countries (Racey, Withrow, and Gesink 2013; Verdoodt et al 2015), and in recent research studies completed in the U.S. (Crosby et al 2015; Galbraith et al 2014; Montealegre et al 2015; Nelson et al 2015; Scarinci et al 2013). Most studies conducted in the U.S. have found that women were receptive to having an HPV self-test mailed to their home and to completing the test; these studies reported many of the same concerns, especially about correctly completing the test (Galbraith et al 2014; Nelson et al 2015).…”

Comparison of initial stream urine samples and cervical samples for detection of human papillomavirus

“…Hence, single genotyping is important to design preventive strategies, to study the carcinogenic potential of HPV types and improve the triage of HPV positive woman by single type risk esterification, and to follow-up persistent infections [8]. Then, selfcollection of samples for high-risk HPV testing can be performed outside a health facility to increase ease of and access to screening uptake [11] due to non-invasive, easily accessible [16]. In fact, urine testing has been successful for the detection of common sexually transmitted infections, such as Chlamydia trachomatis and Neisseria gonorrhoeae [17].…”

“…Anyplex™ II HPV28 detection kit detects simultaneously 19 high-risk HPVs (16,18,26,31,33,35,39,45, 51, 52, 53, 56, 58,59, 66, 68, 69, 73, 82) and 9 low-risk HPVs (6,11,40,42,43,44,54,61,70), which allows the screening and identification of the most clinically relevant HPV types. The inclusion of internal control allows check the entire process from DNA extraction to PCR amplification.…”

“…In the United States, an estimated 56% of incident invasive cervical cancer is due to insufficient screening [10]. Then, self-collection of samples for high-risk HPV testing can be performed outside a health facility to increase ease of and access to screening uptake [11], and has been found highly acceptable in different populations [12]. Urine collection for high-risk HPV detection could provide an especially simple, non-invasive method for screening women reluctant to undergo a pelvic examination.…”

The acceptability of self-sampled screening for HPV DNA: a systematic review and meta-analysis

“…Although self-sampling is established as an effective strategy for detecting cervical cancer, it is less clear whether women view this as an acceptable screening option 17. The purpose of this systematic review and meta-analysis was to assess women's acceptability of self-sampling for HPV DNA testing and their preference for self-sampling compared with clinician-collected samples for the purpose of cervical cancer screening.…”