Role of Self-Sampling for Cervical Cancer Screening: Diagnostic Test Properties of Three Tests for the Diagnosis of HPV in Rural Communities of Cuenca, Ecuador

Bernardo Vega Crespo, Vivian Alejandra Neira, José Ortíz Segarra, Ruth Maldonado Rengel, Diana López, María Paz Orellana, Andrea Gómez, María José Vicuña, Jorge Mejía, Ina Benoy, Tesifón Parrón Carreño and Veronique Verhoeven
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Bernardo Vega Crespo: Facultad de Ciencias Médicas, Universidad de Cuenca, Cuenca 010203, Ecuador
Vivian Alejandra Neira: Facultad de Ciencias Médicas, Universidad de Cuenca, Cuenca 010203, Ecuador
José Ortíz Segarra: Facultad de Ciencias Médicas, Universidad de Cuenca, Cuenca 010203, Ecuador
Ruth Maldonado Rengel: Facultad de Ciencias de la Salud, Universidad Técnica Particular de Loja UTPL Loja Ecuador, Loja 1101608, Ecuador
Diana López: Facultad de Medicina, Universidad del Azuay UDA, Cuenca 010104, Ecuador
María Paz Orellana: Facultad de Ciencias Médicas, Universidad de Cuenca, Cuenca 010203, Ecuador
Andrea Gómez: Facultad de Ciencias Médicas, Universidad de Cuenca, Cuenca 010203, Ecuador
María José Vicuña: Facultad de Ciencias Médicas, Universidad de Cuenca, Cuenca 010203, Ecuador
Jorge Mejía: Facultad de Ciencias Médicas, Universidad de Cuenca, Cuenca 010203, Ecuador
Ina Benoy: AMBIOR, Laboratory for Cell Biology & Histology, University of Antwerp, 2610 Antwerp, Belgium
Tesifón Parrón Carreño: Facultad de Ciencias de la Salud y Neurociencias, Universidad de Almería UAL, 04120 Almería, Spain
Veronique Verhoeven: Family Medicine and Population Health, University of Antwerp, 2610 Antwerp, Belgium

IJERPH, 2022, vol. 19, issue 8, 1-10

Abstract: Background: HPV primary screening has shown effectiveness for cancer prevention; however, gynaecological examination is considered uncomfortable. Self-sampling methods increase the acceptance of screening. The aim of this study is to compare the sensitivity and specificity of clinician sampling versus vaginal and urine self-sampling for HPV diagnosis. Methods: A diagnostic test study was conducted in a rural parish of Cuenca, Ecuador. A total of 120 women participated. Each participant self-collected urine and vaginal samples and underwent clinician sampling for HPV testing. The latter was considered as the golden standard. All three samples were processed with the same amplification and hybridization protocol for HPV detection (Hybribio) following the manufacturer’s instructions. Results: Characteristics of the participants were: median age 35 years; 40.8% married; 46.7% had a primary level of education; and median age of sexual onset, 17.6 years. The prevalence of any type of HPV with clinician sampling was 15.0%, 17.5% with urine sampling and 18.3% with vaginal self-sampling. Self-sampling sensitivity reached 94.4% (IC 74.2–99.9), and specificity 92.1% (IC 85.2–95.9). Urine sampling had a sensitivity of 88.8% (IC 67.2, 96.9), and specificity 94.1% (IC 67.2–96.9). The negative predictive value was 98.9% (IC 94.2–99.8) for vaginal self-sampling and 97.6% (IC 92.6–99.4) for urine sampling. Conclusions: This study shows that vaginal and urine self-sampling methods have similar sensitivity and specificity compared with clinician sampling for the diagnosis of HPV. The correlation between HPV genotypes among the three tests is satisfactory.

Keywords: HPV; self-sampling; urine sampling; clinician sampling; sensitivity and specificity (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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