Human papillomavirus DNA testing on self-collected vaginal tampon samples as a cervical cancer screening test in a Gauteng population

摘要

BACKGROUND: There is a need to simplify cervical cancer screening to reach more women. Tampon-collectedspecimens can be tested using molecular methods, but this type of self-screening has not been properlyevaluated as a screening method in South Africa before. The objective of this study was to evaluate humanpapillomavirus (HPV) DNA testing of self-collected tampons as a screening method in an urban and peri-urbanpopulation in Gauteng by comparing the results with the current standard of conventional cytology. In addition,HPV prevalence, type, distribution and incidence of cytological abnormalities in this population are described.METHOD: Seven hundred and twenty women attending public healthcare facilities in and around Tshwane,Gauteng province, were invited to participate. The women collected a tampon sample for molecular testing, andwere then screened by healthcare workers collecting a conventional cervical cytology smear. HPV testing wasundertaken using the Linear Array® HPV Genotyping Test (Roche Molecular Systems).RESULTS: Data for analysis were available for 631 women. Three hundred and fifty-four (58%) were positive for highriskHPV, while (15.4%) had an abnormal cytology result. Women aged 30-39 years had the highest prevalenceof both high-risk HPV (75%) and abnormal cytology (22%). Infection with multiple types was common. Higherriskviruses were not over-represented in, and no dramatic decrease in HPV prevalence was observed in, olderwomen. Cytological abnormalities were detected in only 3.74% of women who tested negative for high-risk HPV,but were found in 24.2% of high-risk HPV positive women.CONCLUSION: HPV testing on self-collected tampon samples was feasible, highly sensitive and demonstrated ahigh negative predictive value for current cytological abnormalities in this population.