Accuracy of self‐collected human papillomavirus samples from Japanese women with abnormal cervical cytology

AbstractAimThe aim of this study was to assess the accuracy of self‐collected vaginal samples compared with physician‐collected cervical samples for high‐risk human papillomavirus (HPV) testing in Japanese women with abnormal cervical cytology. We also assessed the acceptability of self‐collected HPV (sHPV) testing using a questionnaire.MethodsWomen aged 20–69 years (n = 136) attending Yokohama City University Hospital because of abnormal cervical cytology between April 2014 and January 2015 were enrolled in this study. Cervical samples for conventional cytology and physician‐collected HPV (pHPV) testing were obtained before colposcopic examination. After this examination, patients were asked to provide a self‐sampled vaginal specimen (sHPV) at home, some time between the following day and the next week and to complete a self‐sampling acceptability questionnaire.ResultsThe overall positive rates of HPV detection with pHPV and sHPV testing were 61.0% (83/136) and 40.4% (55/136), respectively (P < 0.001). sHPV testing had a lower sensitivity compared to pHPV for detection of cervical intraepithelial neoplasia (CIN)2 or worse (CIN2+: 59.4% vs 100%, P < 0.001; CIN3: 66.7% vs 100%, P = 0.248). There were no statistically significant differences in the sensitivity to detect CIN3 among pHPV testing, sHPV testing, and cytology. The self‐collecting device had good acceptability.ConclusionsHPV testing is a possible technique with which to improve poor cervical cancer screening uptake rates in Japan; however, the sensitivity to detect CIN2+ lesions must improve before it can be a substitute for conventional cytology or pHPV testing. Further large‐scale acceptability studies involving non‐responders are also needed before practical application.