Self-collected specimens for testing human papillomavirus

In this Research letter, Dr. Gina Ogilvie and colleagues investigate the feasibility of self-collection of specimens for HPV testing among women who may not make full use of cytology screening programs (e.g., women who are homeless or who are involved in the sex trade) and are thus at increased risk of cervical cancer.

To study the feasibility of self-collected specimens for testing human papillomavirus (HPV) status among hard-to-reach women, outreach nurses recruited women in women's centres, shelters and alleys in Vancouver's Downtown Eastside. Of the 151 participants for whom samples were available, 43 (28.5%) tested positive for high-risk HPV. Outreach nurses were able to recontact 81.4% of the participants who tested positive and referred them for further testing. About 14% (21/151) of participants had never received a Papanicolaou smear in British Columbia, as compared with 8.3% (608/7336) of women in the BC general population (p < 0.05).

The authors' findings suggest that self-collection of specimens is feasible for women who are at high risk of cervical cancer and who do not receive routine cervical cancer screening.

Future studies should include an examination of the rate of follow-up testing among women found to be positive for high-risk HPV. In addition, improved methods are necessary to enhance uptake of follow-up interventions. As well, given the high incidence of this preventable cancer in developing countries, self-collection of specimens for HPV screening could be offered as a component of reproductive health programs and could be administered by health care workers to improve access to cervical cancer screening. Follow-up using screen-and-treat methods could then be used to offer definitive treatment for women at risk for cervical cancer.