RESUMO
BACKGROUND: Recent studies have reported high sensitivity of human papillomavirus (HPV) testing from self-collected vaginal specimens. These results suggest the possibility of introducing self-collection of samples for cervical cancer screening to increase overall participation. The current study compared test results from self-collected and physician-collected specimens. PATIENTS AND METHODS: Vaginal samples from patients (n = 102) of a colposcopy clinic were taken by both a physician and themselves. All cell samples were tested using cytological diagnostics with a PAP test and for carcinogenic HPV genotypes (Cervista®). Additionally, all patients had a colposcopy (86% with cervical biopsy) and in 40% of patients was carried out a conisation. RESULTS: Of the patients tested 50 had the histological diagnosis of a cervical intraepithelial neoplasia grade 2 (CIN 2+ or 3). Sensitivity of HPV self-collected samples was much lower than that of physician-collected samples (72 % compared to 92 %). The sensitivity of self-collected PAP tests was only 52 % but the positive predictive value of self-collected PAP tests was very high. The cytological diagnosis of high-grade intraepithelial lesion (HSIL) correlated much better with the histological results of conisation (96 %) than with cervical biopsies (76 %). CONCLUSION: The results of this study indicate that self-collection may not provide an adequate collection method for improving efficiency in cervical cancer screening in Germany.
