OBJECTIVE: To compare the detection rate of genital human papillomavirus (HPV) infection in self- and physician-obtained samples. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Studies published between 1966 and November 2005 identified through Medline and Embase that compared both sampling methods. MAIN OUTCOME MEASURES: We calculated the concordance and kappa statistic between physician- and self-sampling and the difference between proportions of HPV positive samples. Weighted averages were reported with 95% confidence intervals (CI) using a random-effects model. RESULTS: Eighteen studies (5441 participants) were included that evaluated broad HPV type categories, 10 (3688 patients) that of high-risk (HR) HPV and three (530) that of low-risk (LR) HPV. A high level of concordance of 0.87 (95%CI, 0.82 to 0.91) between self- and physician-sampling was obtained for detection of HPV DNA (kappa 0.66, 95%CI, 0.56 to 0.76). The prevalence difference of HPV DNA between sampling methods was -0.5 (95%CI, -2.8 to 1.8). Results were similar when restricting the analysis to HR-HPV but the prevalence of LR-HPV types was higher in self-collected samples. CONCLUSION: Self-sampling was as sensitive as physician-obtained sampling to detect HR-HPV or HPV DNA. Self-sampling may be a suitable alternative method for studies on HPV transmission and vaccine trials.
OBJECTIVE: To compare the detection rate of genital human papillomavirus (HPV) infection in self- and physician-obtained samples. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Studies published between 1966 and November 2005 identified through Medline and Embase that compared both sampling methods. MAIN OUTCOME MEASURES: We calculated the concordance and kappa statistic between physician- and self-sampling and the difference between proportions of HPV positive samples. Weighted averages were reported with 95% confidence intervals (CI) using a random-effects model. RESULTS: Eighteen studies (5441 participants) were included that evaluated broad HPV type categories, 10 (3688 patients) that of high-risk (HR) HPV and three (530) that of low-risk (LR) HPV. A high level of concordance of 0.87 (95%CI, 0.82 to 0.91) between self- and physician-sampling was obtained for detection of HPV DNA (kappa 0.66, 95%CI, 0.56 to 0.76). The prevalence difference of HPV DNA between sampling methods was -0.5 (95%CI, -2.8 to 1.8). Results were similar when restricting the analysis to HR-HPV but the prevalence of LR-HPV types was higher in self-collected samples. CONCLUSION: Self-sampling was as sensitive as physician-obtained sampling to detect HR-HPV or HPV DNA. Self-sampling may be a suitable alternative method for studies on HPV transmission and vaccine trials.
Authors: M F D Baay; V Verhoeven; H A J Lambrechts; G G O Pattyn; F Lardon; P Van Royen; J B Vermorken Journal: Eur J Clin Microbiol Infect Dis Date: 2009-07-15 Impact factor: 3.267
Authors: Roosmarie P de Bie; Channa E Schmeink; Judith M J E Bakkers; Peter J F Snijders; Wim G V Quint; Leon F A G Massuger; Ruud L M Bekkers; Willem J G Melchers Journal: J Mol Diagn Date: 2011-04-29 Impact factor: 5.568