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HPV self-testing complemented current cervical cancer screening methods
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The incorporation of human papillomavirus self-testing complemented the current national cervical cancer screening program in China by increasing coverage of unscreened populations and more sensitive detection of cervical cancers and precursor lesions, according to You-Lin Qiao, MD, PhD.
“Although it is not specific enough to be a stand-alone test, self-HPV testing provides sensitive results without pelvic exams, medical professionals or health care facilities, and thus has the potential to serve as a primary cervical cancer screening method for women, regardless of their geographic location or access to health care,” Qiao, of Peking Union Medical College in Beijing, told Infectious Disease News.
The researchers set out to assess self-collected cervicovaginal specimens tested for HPV as a primary cervical cancer screening method in low-resource settings in China.
Patient data were pooled from five population-based cervical cancer screening studies. The researchers compared the accuracy of self-HPV testing, physician-HPV testing, liquid-based cytology and visual inspection with acetic acid in detecting cervical intraepithelial neoplasia grade 2 (CIN2+) or more (CIN3+).
They found that self-HPV testing resulted in 86.2% sensitivity and 80.7% specificity for detecting CIN2+; and 86.1% sensitivity and 79.5% specificity for detecting CIN3+.
Compared with self-HPV testing, visual inspection with acetic acid showed significantly lower sensitivity for detecting CIN2+ (50.3%) and CIN3+ (55.7%), yet higher specificity for detecting CIN2+ (87.4%) and CIN3+ (86.9%; P<.001); liquid-based cytology showed lower sensitivity for detecting CIN2+ (80.7%; P=.015), similar sensitivity for detecting CIN3+ (89%; P=.341), and higher specificity for detecting CIN2+ (94%; P<.001) and CIN3+ (92.8%; P<.001).
Physician-HPV testing was more sensitive for detecting CIN2+ (97%) and CIN3+ (97.8%), but similarly specific for detecting CIN2+ (82.7%) and CIN3+ (81.3%; P<.001), according to the study.
In an accompanying editorial, Patrick Petignat, MD, of the University Hospitals of Geneva, and Pierre Vassilakos, MD, of the Geneva Foundation for Medical Education and Research, wrote, “The feasibility and impact of introducing this method outside research settings requires further evaluation.”
For more information:
- Petignat P. J Natl Cancer Inst. 2012;doi:10.1093/jnci/djr544
- Zhao FH. J Natl Cancer Inst. 2012;doi:10.1093/jnci/djr532.
Disclosure: This research was supported by the Fogarty International Clinical Research Scholars Program (Fogarty International Center, NIH; R24 TW007988); and the Academic Capacity Development Program of the Beijing Municipal Commission of Education grant (XK100230447).
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