Extended HPV Genotyping to Compare HPV Type Distribution in Self- and Provider-Collected Samples for Cervical Cancer Screening

Abstract

Background: Primary high-risk human papillomavirus (hr-HPV) testing of self-collected cervico-vaginal swabs could increase cervical cancer screening coverage, although triage strategies are needed to reduce unnecessary colposcopies. We evaluated the use of extended hr-HPV genotyping of self-collected samples for cervical cancer screening. Methods: We recruited women ages 25–65 years at two colposcopy clinics in North Carolina between November 2016 and January 2019, and obtained self-collected cervico-vaginal samples, provider-collected cervical samples, and cervical biopsies from all enrolled women. Self- and provider-collected samples were tested for 14 hr-HPV genotypes using the Onclarity Assay (Becton Dickinson). We calculated hr-HPV genotype–specific prevalence and assessed agreement between results in self- and provider-collected samples. We ranked the hr-HPV genotypes according to their positive predictive value (PPV) for the detection of cervical intraepithelial neoplasia (CIN) grade 2 or higher (CIN2+). Results: A total of 314 women participated (median age, 36 years); 85 women (27%) had CIN2+. More women tested positive for any hr-HPV on self-collected (76%) than on provider-collected samples (70%; P = 0.009) with type-specific agreement ranging from substantial to almost perfect. HPV-16 was the most common genotype in self-collected (27%) and provider-collected samples (20%), and HPV-16 prevalence was higher in self- than provider-collected samples (P < 0.001). In self- and provider-collected samples, HPV-16 had the highest PPV for CIN2+ detection. Conclusions: Overall sensitivity for CIN2+ detection was similar for both sample types, but the higher HPV-16 prevalence in self-collected samples could result in increased colposcopy referral rates. Impact: Additional molecular markers might be helpful to improve the triage of women who are hr-HPV positive on self-collected samples.

Cost-Effectiveness Analysis of HPV Extended versus Partial Genotyping for Cervical Cancer Screening in Singapore

“…Additionally, hrHPV may be reclassified to a lower-risk category along with HPV66 [ 3 ]. To date, however, XGT is not widely implemented in Asia, and experience with the technology is limited to western countries such as the U.S. [ 74 ], Canada [ 75 ], Denmark [ 76 ], and Italy [ 77 ]. For the wider adoption of XGT, it is critical to drive awareness of the higher risk of non-HPV16/18 infections and PSGI, which has been well documented [ 8 , 9 , 72 ].…”

Human papillomavirus genotype distribution among women with and without cervical cancer: Implication for vaccination and screening in Ghana

“…Three specimens were collected: exfoliated cervical cells, fresh biopsy, and paraffin-embedded samples. HPV genotyping from a cervical sample is influenced by specimen type [ 47 , 48 ]. However, a validation study comparing HPV DNA detection rates from exfoliated cervical cells and biopsy specimens from the same subject did not detect a significant difference [ 49 ].…”

Human papilloma virus infection and its associated risk for cervical lesions: a cross-sectional study in Putuo area of Shanghai, China

“…These subtypes of HPV infections might be the focus of prevention and treatment of cervical cancer in the future. Previous studies have shown that persistent infection of the HPV 16 subtype is closely related to cervical cancer, and HPV 16, HPV 52, and HPV 58 cause specific cancer in Chinese women, so secondary prevention against cervical cancer is still essential in regional screening [17][18][19]. Because chronic cervicitis leads to cervical cancer under chronic HPV virus repeated infection, long-term follow-up is still necessary [20,21].…”