Comparison of vaginal self-sampling and cervical sampling by medical professionals for the detection of HPV and CIN2+: a randomized study
Mené sur 11 951 participantes âgées de 30 à 60 ans, cet essai randomisé évalue, du point de vue de la prévalence du papillomavirus humain et du taux de détection de lésions cervicales intra-épithéliales de grade 2 ou supérieur, l'équivalence entre un auto-prélèvement cervical et un prélèvement effectué par un professionnel de santé
Abstract Primary screening with human papillomavirus (HPV) test is more effective in reducing cervical cancer incidence than cytology and it also offers the opportunity to self-sample. We conducted a randomized study to compare vaginal self-sampling with cervical sampling by medical professionals for HPV testing concerning prevalence of HPV and detection of cervical intraepithelial neoplasia (CIN) of grade 2 or worse (CIN2+) or grade 3 or worse (CIN3+) in primary screening. In total, 11 951 women aged 30?60?years were randomized into two groups, 5961 for self-sampling (SS arm) and 5990 for sampling by medical professionals (SMP arm). Sampling was performed with a Rovers?Viba-brush in the SS arm and a cytobrush in the SMP arm. All samples were applied to an indicating FTA elute card and analyzed for HPV using a clinically validated real-time PCR test (hpVIR). All HPV-positive women performed repeated sampling about six months later using the same procedure as used initially. All HPV-positive women in the second sampling were referred to colposcopy. The prevalence of HPV in the first test did not differ between the SS arm (6.8%, 167/2466) and the SMP arm (7.8%, 118/1519) (p=0.255). The prevalence of CIN2+ per 1000 screened women was 17 (43/2466 ??1000) (95%CI 13?24) in the SS arm and 21 (32/1519 ??1000) (95%CI 15?30) in the SMP arm. For CIN3+, the prevalence per 1000 screened women was 14 (35/2466 ??1000) (95%CI 10?20) in the SS arm and 15 (23/1519 ??1000) (95%CI 10?23) in the SMP arm. In conclusion, self-sampling and sampling by medical professionals showed the same prevalence of HPV and detection rate of CIN2+ and CIN3+ in histology. This article is protected by copyright. All rights reserved.
International Journal of Cancer , résumé, 2021