Comparison of Self- To Provider-Collected Cervical Screening with HPV DNA Test at Roi Et Province, Thailand during COVID-19 Pandemic

Abstract

Objective: The authors evaluated the concordance of positivity of self- and provider-sampling collection for high-risk human papillomavirus (hrHPV) DNA assay. Acceptance towards self-collection was also explored. Materials and Methods: Five hundred thirty-five paired self- and provider-sampling cervical specimens were obtained from 30 to 59-year-old women enrolled at the gynecologic clinic at Phanomphrai Hospital, Roi Et Province, Thailand. Women performed self- and then received provider-sampling collection by trained nurse. Each sample was tested by COBAS® 4800 assay. Concordance in hrHPV detection between sample types was determined using Kappa (k) statistics. Sensitivity and specificity of hrHPV detection by self-collection were calculated. A hundred women were randomly invited to answer satisfaction survey afterward. Results: Twenty-seven or 5.0% of the women were positive for hrHPV DNA, which 5, 4, and 18 were HPV-16, 18, and other pooled hrHPV genotypes, respectively. Self-collection showed good concordance to provider-collection (k=0.89; p<0.001). Self-collection of hrHPV detection had sensitivity of 81.5% (95% CI 61.9 to 93.7) and specificity of 100% (95% CI 99.3 to 100). Ninety-five percent of randomly selected 100 women were satisfied with self-collection. Conclusion: Self-collected cervical sampling was comparable to provider-collected HPV DNA testing and was well-accepted. The present modality may help accelerate achieving the goal of elimination of cervical cancer campaign during the recovery phase of covid-19 pandemic.