Traditional vs novel out-of-office method for collecting cytology and HPV DNA — a comparative study
, 2, 1, 1, 3, 3, 3, 1, 1
Abstract
Objectives: The integration of high-risk human papillomavirus (HPV) detection into cervical cancer screening in Poland aims to improve early detection, yet challenges in coverage and adherence persist. Innovative approaches, like sampling for HPV testing and cytology outside medical settings, have been proposed. This study assesses the feasibility and agreement of results between traditional and novel sampling methods.
Material and methods: A cohort of 50 women aged 25–74 underwent HPV DNA and liquid-based cytology sampling both in-office using standard method and outside the medical setting by trained personnel. Samples were analyzed for HPV DNA using Real-Time PCR and cytology according to the Bethesda System.
Results: Cytology and HPV DNA positivity rates showed substantial agreement between methods, with almost perfect agreement for high-risk HPV types. Visual assessment of the cervix was successfully conducted in all cases. Preliminary results suggest remote sampling for HPV DNA and cytology is a viable alternative to traditional methods, with the effectiveness in detecting HPV and cytological abnormalities comparable to this reported in literature, offering potential benefits for individuals with mobility limitations or logistical barriers to attending medical appointments.
Conclusions: The study highlights the potential role of remote sampling for HPV DNA and cytology in enhancing cervical cancer screening accessibility and adherence. Implementation of such methods could improve coverage, particularly among underserved populations. Further research is needed to validate and optimize these approaches for broader clinical use.
Keywords: HPV testingcervical cancerimmobilized patientsscreening test
References
- Polish Gynecology Society recommendations on cervical cancer screening scheme. https://kolposkopia.info/rekomendajce/stanowisko-dotyczace-schematu-postepowania-w-skriningu-podstawowym-raka-szyjki-macicy-polskiego-towarzystwa-ginekologow-i-poloznikow-ptgip-czerwiec-2022-roku/ (04.02.2024).
- Arbyn M, Gultekin M, Morice P, et al. The European response to the WHO call to eliminate cervical cancer as a public health problem. Int J Cancer. 2021; 148(2): 277–284.
- Data on the implementation of National Polish Health Care System screening programs: http://www.nfz.gov. https://www.nfz.gov.pl/dla-pacjenta/programy-profilaktyczne/dane-orealizacji-programow/ (04.02.2024).
- Bennett KF, Waller Jo, Chorley AJ, et al. Barriers to cervical screening and interest in self-sampling among women who actively decline screening. J Med Screen. 2018; 25(4): 211–217.
- Logan L, McIlfatrick S. Exploring women's knowledge, experiences and perceptions of cervical cancer screening in an area of social deprivation. Eur J Cancer Care (Engl). 2011; 20(6): 720–727.
- Gibert MJ, Sánchez-Contador C, Artigues G. Validity and acceptance of self vs conventional sampling for the analysis of human papillomavirus and Pap smear. Sci Rep. 2023; 13(1): 2809.
- Ajenifuja KO, Belinson J, Goldstein A, et al. Designing low-cost, accurate cervical screening strategies that take into account COVID-19: a role for self-sampled HPV typing2. Infect Agent Cancer. 2020; 15: 61.
- Hawkes D, Keung MHT, Huang Y, et al. Self-Collection for Cervical Screening Programs: From Research to Reality. Cancers (Basel). 2020; 12(4).
- Arbyn M, Smith SB, Temin S, et al. Collaboration on Self-Sampling and HPV Testing. Detecting cervical precancer and reaching underscreened women by using HPV testing on self samples: updated meta-analyses. BMJ. 2018; 363: k4823.
- Polish recommendation on cervical cancer screening during SARS-CoV-2 pandemic https://kolposkopia.info/wp-content/uploads/2023/06/SkriningRakaSzyjkiMacicyWPolsceWOkresiePandemiiSARS-CoV-2_TymczasoweRekomendacje-. https://ptgin.pl/sites/scm/files/2021-12/01.2021%20Skrining%20raka%20szyjki%20macicy%20w%20POlsce%20w%20okresie%20pandemii%20SARS-CoV-2%20TYmczasowe%20Rekomendacje.pdf (04.02.2024).
- Landis J, Koch G. The Measurement of Observer Agreement for Categorical Data. Biometrics. 1977; 33(1): 159.
- Gibert MJ, Sánchez-Contador C, Artigues G. Validity and acceptance of self vs conventional sampling for the analysis of human papillomavirus and Pap smear. Sci Rep. 2023; 13(1): 2809.
- Martinelli M, Giubbi C, Di Meo ML, et al. Accuracy of Human Papillomavirus (HPV) Testing on Urine and Vaginal Self-Samples Compared to Clinician-Collected Cervical Sample in Women Referred to Colposcopy. Viruses. 2023; 15(9).
- Sankaranarayanan R, Shyamalakumary B, Wesley R, et al. Visual inspection with acetic acid in the early detection of cervical cancer and precursors. International Journal of Cancer. 1999; 80(1): 161–163, doi: 10.1002/(sici)1097-0215(19990105)80:1<161::aid-ijc28>3.0.co;2-8.
- Hu L, Bell D, Antani S, et al. An Observational Study of Deep Learning and Automated Evaluation of Cervical Images for Cancer Screening. J Natl Cancer Inst. 2019; 111(9): 923–932.
- Perkins R, Jeronimo J, Hammer A, et al. Comparison of accuracy and reproducibility of colposcopic impression based on a single image versus a two-minute time series of colposcopic images. Gynecol Oncol. 2022; 167(1): 89–95.
- Goldie SJ, Kuhn L, Denny L, et al. Policy analysis of cervical cancer screening strategies in low-resource settings: clinical benefits and cost-effectiveness. JAMA. 2001; 285(24): 3107–3115.
- Denny L, Kuhn L, Risi L, et al. Two-stage cervical cancer screening: an alternative for resource-poor settings. Am J Obstet Gynecol. 2000; 183(2): 383–388.
