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document
A comparison of human papillomavirus testing of clinician-collected and self-collected samples during follow-up after screen-and-treat . Screen-and-treat cervical cancer prevention programs based on high-risk human papillomavirus ( HPV ) testing and cryotherapy have been shown to be effective in resource-limited settings . However , because cryotherapy is not 100 % effective , follow-up is needed after treatment to detect post-treatment failures . We compared the test performances of high-risk HPV testing ( Hybrid Capture 2 ) using self-collected and clinician-collected samples as well as cervical cytology for identifying cervical intraepithelial neoplasia grades 2 or 3 or invasive cervical cancer ( CIN2+ ) among women who did ( n=812 ) and did not ( n=1858 ) undergo cryotherapy in a South African screen-and-treat trial . At 6 months after enrolment ( and after cryotherapy , if performed ) , women were tested using all three screening methods and then underwent colposcopy/biopsy . A predefined subset of women ( n=1,455 ) had extended follow-up with colposcopy/biopsy at 12 months . A total of 33 and 91 cases of CIN2+ were detected among treated and untreated women , respectively . The sensitivity of HPV testing using clinician-collected samples and cervical cytology did not differ by treatment status . HPV testing of clinician-collected samples detected the most cases of CIN2+ among both treated ( 85 % ) and untreated ( 91 % ) women ( p=0.31 ) . Cytology ( at a cutoff of atypical squamous cells of undetermined significance or greater ) detected 76 % of cases among both treated and untreated women . However , the sensitivity of HPV testing using self-collected samples was significantly lower among treated versus untreated women ( 55 % vs. 78 % , p=0.01 ) . HPV testing using self-collected vaginal specimens may be useful in primary screening but performs poorly for detecting post-treatment failures .
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Intervention_Physical
clinician-collected and self-collected samples
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Intervention_Physical
self-collected and clinician-collected samples
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Intervention_Physical
cervical cytology
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Intervention_Physical
cryotherapy
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Intervention_Physical
colposcopy/biopsy
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Intervention_Physical
colposcopy/biopsy
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Intervention_Physical
clinician-collected samples
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Intervention_Physical
clinician-collected samples
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Intervention_Physical
self-collected samples
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Intervention_Physical
self-collected vaginal specimens
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Outcome_Physical
sensitivity of HPV testing
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Outcome_Physical
CIN2+
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Outcome_Other
Cytology
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Outcome_Physical
sensitivity of HPV testing
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Outcome_Adverse-effects
post-treatment failures
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Participant_Sex
women
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Participant_Sample-size
n=812
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Participant_Sample-size
n=1858