Self-Administered HPV Test Helps Screen for Cervical Cancer

Patient-collected specimens for human papillomavirus (HPV) DNA testing detected precancerous cervical lesions with an accuracy comparable to that of liquid-based cytology (LBC) and visual inspection with acetic acid, according to a new study.

Researchers at Peking Union Medical College (PUMC; Beijing, China), Mount Sinai School of Medicine (New York, NY, USA), and other institutions worldwide reviewed patient data from five population-based cervical cancer–screening studies in China. In all, 13,140 participants underwent Self-HPV testing, physician-collected cervical specimens for HPV testing, LBC, and visual inspection with acetic acid (VIA). Screen-positive women had a subsequent colposcopy and confirmatory biopsy. The researchers than analyzed the accuracies of pooled Self-HPV testing, Physician-HPV testing, VIA, and LBC to detect biopsy-confirmed cervical intraepithelial neoplasia grade 2 or more severe (CIN2+), and CIN3+.

The results showed that 3.9% of the women were diagnosed as CIN2+, 2.1% as CIN3+, and 0.3% with cervical cancer. Self-HPV testing had 86.2% sensitivity and 80.7% specificity for detecting CIN2+, and 86.1% sensitivity and 79.5% specificity for detecting CIN3+. VIA had statistically significantly lower sensitivity for detecting CIN2+ and CIN3+, and higher specificity for detecting CIN2+ and CIN3+ than Self-HPV testing, while LBC had lower sensitivity for detecting CIN2+, similar sensitivity for detecting CIN3+, and higher specificity for detecting CIN2+ and CIN3+ than Self-HPV testing. Physician-HPV testing, on the other hand, was more sensitive for detecting CIN2+ and CIN3+, but similarly specific for detecting CIN2+ and CIN3+ than Self-HPV testing.

“Although it is not specific enough to be a stand-alone test, self-HPV testing provides sensitive results without pelvic exams, medical professionals, or healthcare facilities and thus has the potential to serve as a primary cervical cancer screening method for women, regardless of their geographic location or access to healthcare,” concluded lead author You-Lin Qiao, MD, PhD, of PUMC. “Limited resources can then be focused on the clinical follow up of the smaller percentage of women who tested positive.”

One-seventh of all cervical cancers worldwide occur in China, which lacks a national screening program. Self-collected cervicovaginal specimens tested for HPV DNA could therefore effectively serve as a primary cervical cancer screening method in China and other low-resource settings.

Related Links:
Peking Union Medical College
Mount Sinai School of Medicine