Cervical cancer screening: Impact of collection technique on human papillomavirus detection and genotyping

Alisa P. Young; Mutiya Olorunfemi; Leigh Morrison; Scott A. Kelley; Anna Laurie; Anna McEvoy; Jill Schneiderhan; Julie Prussack; Marie Claire O'Dwyer; Pamela Rockwell; Philip Zazove; Jonathan Gabison; Jane Chargot; Kristina Gallagher; Ananda Sen; Dongru Chen; Elizabeth A. Haro; Emma A. Butcher; Martha L. Alves; Christelle El Khoury; Melinda L. Dendrinos; Nicole Brashear; Roger Smith; Richard W. Lieberman; Natalie Saunders; Elizabeth Campbell; Heather M. Walline; Diane M. Harper

Preventive Medicine Reports (Feb 2025)

Cervical cancer screening: Impact of collection technique on human papillomavirus detection and genotyping

Alisa P. Young,
Mutiya Olorunfemi,
Leigh Morrison,
Scott A. Kelley,
Anna Laurie,
Anna McEvoy,
Jill Schneiderhan,
Julie Prussack,
Marie Claire O'Dwyer,
Pamela Rockwell,
Philip Zazove,
Jonathan Gabison,
Jane Chargot,
Kristina Gallagher,
Ananda Sen,
Dongru Chen,
Elizabeth A. Haro,
Emma A. Butcher,
Martha L. Alves,
Christelle El Khoury,
Melinda L. Dendrinos,
Nicole Brashear,
Roger Smith,
Richard W. Lieberman,
Natalie Saunders,
Elizabeth Campbell,
Heather M. Walline,
Diane M. Harper

Affiliations

Alisa P. Young: Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
Mutiya Olorunfemi: Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
Leigh Morrison: Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
Scott A. Kelley: Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
Anna Laurie: Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
Anna McEvoy: Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
Jill Schneiderhan: Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
Julie Prussack: Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
Marie Claire O'Dwyer: Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
Pamela Rockwell: Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
Philip Zazove: Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
Jonathan Gabison: Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
Jane Chargot: Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
Kristina Gallagher: Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
Ananda Sen: Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA; Department of Biostatistics, School of Public Health, 1415 Washington Heights, University of Michigan, Ann Arbor, MI 48109, USA
Dongru Chen: Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
Elizabeth A. Haro: Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
Emma A. Butcher: Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
Martha L. Alves: Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
Christelle El Khoury: Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA
Melinda L. Dendrinos: Department of Obstetrics and Gynecology, 1500 E Medical Center Dr # 9, University of Michigan Medical School, Ann Arbor, MI 48109, USA
Nicole Brashear: Department of Obstetrics and Gynecology, 1500 E Medical Center Dr # 9, University of Michigan Medical School, Ann Arbor, MI 48109, USA
Roger Smith: Department of Obstetrics and Gynecology, 1500 E Medical Center Dr # 9, University of Michigan Medical School, Ann Arbor, MI 48109, USA
Richard W. Lieberman: Department of Obstetrics and Gynecology, 1500 E Medical Center Dr # 9, University of Michigan Medical School, Ann Arbor, MI 48109, USA
Natalie Saunders: Department of Obstetrics and Gynecology, 1500 E Medical Center Dr # 9, University of Michigan Medical School, Ann Arbor, MI 48109, USA
Elizabeth Campbell: Department of Obstetrics and Gynecology, 1500 E Medical Center Dr # 9, University of Michigan Medical School, Ann Arbor, MI 48109, USA
Heather M. Walline: Department of Otolaryngology, 1500 E Medical Center Dr # 1 University of Michigan Medical School, Ann Arbor, MI 48109, USA
Diane M. Harper: Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109, USA; Department of Obstetrics and Gynecology, 1500 E Medical Center Dr # 9, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Corresponding author at: 1018 Fuller Street, Ann Arbor, MI 48105, USA.

Journal volume & issue: Vol. 50
p. 102971

Abstract

Read online

Background: The Food and Drug Administration (FDA) in the US approved primary human papillomavirus (HPV) testing for speculum-based cervical cancer screening ten years ago and, in May 2024, approved the self-collection technique. Our study defines the kappa agreement between self- and speculum-based collection techniques for 15 types of high-risk HPV. Additionally, we describe the sensitivity and specificity ratios for HPV testing using both collection methods. Methods: Participants recruited in 2020–2022 included 97 colposcopy attendees and 96 routine primary care screening attendees aged 30–65, who agreed to self-sample before their clinically scheduled speculum-based exam. Prevalence-based kappa calculated agreement, sensitivity and specificity ratios calculated accuracy using the cervical intraepithelial neoplasia grade 2 or worse (CIN 2+) threshold. Results: The average ages were 45.9 (SD 10.5) and 46.2 (SD 11.0) years for the colposcopy and primary care attendees, respectively. HPV 16, 68, and 39 were the most common types detected. The lower bound of the 95 % Cl for kappa calculations was above 0.81, indicating almost perfect agreement across all HPV genotypes. The sensitivity and specificity ratios were consistent at 1.0 across both collection methods. The HPV positivity rate was significantly higher among colposcopy attendees at 66 % (64/97), compared to 14 % (13/96) among routine primary care screeners. The study identified 17 women with CIN2 + . Conclusions: Primary HPV screening with self-collection is equivalent to speculum-based collection among people aged 30–65. The findings emphasize the utility of self-collection in identifying high-grade lesions and the consistency of HPV detection across different collection methods.

Published in Preventive Medicine Reports

ISSN: 2211-3355 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine
Website: http://www.journals.elsevier.com/preventive-medicine-reports/

About the journal

Abstract

Keywords