Santhosh Kuriakose1, Sasidharanpillai Sabeena2, Damodaran Binesh3, Jazeel Abdulmajeed2, Nagaraja Ravishankar4, Amrutha Ramachandran1, Bindu Vijaykumar5, Nurul Ameen5. 1. Gynecologic Oncology Division, Department of Obstetrics and Gynecology, Government Medical College, Kozhikode, Kerala, India. 2. Manipal Institute of Virology, Manipal Academy of Higher Education, Manipal, Karnataka, India. 3. Department of Radiation Oncology, Government Medical College, Kozhikode, Kerala, India. 4. Department of Data Science, Manipal Academy of Higher Education, Manipal, Karnataka, India. 5. Department of Obstetrics and Gynecology, Government Medical College Kozhikode, Kozhikode, Kerala, India.
Abstract
OBJECTIVES: To assess the efficacy of self-collected vaginal samples compared with physician-collected cervical samples for the detection of HPVDNA. METHODS: A hospital-based cross-sectional study was carried out among patients with newly diagnosed cervical cancer attending the Gynecologic Oncology Division, Department of Obstetrics and Gynecology and Radiation Oncology Department at Government Medical College, Kozhikode, Kerala between March 2017 and April 2019. Consenting patients collected their vaginal samples, followed by cervical sample collection by the clinician. The paired samples were transported at 4-8 °C to the laboratory. Amplification of LCR/E6/E7 regions of the HPV genome was done by polymerase chain reaction (PCR). The agreement level between paired samples was assessed by the Kappa index. RESULTS: Among the 114 cervical cancer patients enrolled in the present cross-sectional study, the prevalence of HPV DNA was 78.1% (95% confidence interval [CI] 69.2%-85%) in cervical samples and 77.2% in vaginal samples (95% CI 68.7%-83.9%). The overall agreement between the two sampling methods was 93.9% and the kappa value was 0.82 (P<0.001). The sensitivity of HPV detection using vaginal samples was 98.9% (95% CI 93.9%-99.8%) and the specificity was 100% (95% CI 86.7%-100%) with cervical sampling as the gold standard. By Kappa index, an almost perfect agreement for HPV DNA detection between self-collected and physician-collected samples was observed. CONCLUSION: Self-collection of vaginal samples ensures equity of cervical cancer screening in low-income countries such as India.
OBJECTIVES: To assess the efficacy of self-collected vaginal samples compared with physician-collected cervical samples for the detection of HPVDNA. METHODS: A hospital-based cross-sectional study was carried out among patients with newly diagnosed cervical cancer attending the Gynecologic Oncology Division, Department of Obstetrics and Gynecology and Radiation Oncology Department at Government Medical College, Kozhikode, Kerala between March 2017 and April 2019. Consenting patients collected their vaginal samples, followed by cervical sample collection by the clinician. The paired samples were transported at 4-8 °C to the laboratory. Amplification of LCR/E6/E7 regions of the HPV genome was done by polymerase chain reaction (PCR). The agreement level between paired samples was assessed by the Kappa index. RESULTS: Among the 114 cervical cancerpatients enrolled in the present cross-sectional study, the prevalence of HPV DNA was 78.1% (95% confidence interval [CI] 69.2%-85%) in cervical samples and 77.2% in vaginal samples (95% CI 68.7%-83.9%). The overall agreement between the two sampling methods was 93.9% and the kappa value was 0.82 (P<0.001). The sensitivity of HPV detection using vaginal samples was 98.9% (95% CI 93.9%-99.8%) and the specificity was 100% (95% CI 86.7%-100%) with cervical sampling as the gold standard. By Kappa index, an almost perfect agreement for HPV DNA detection between self-collected and physician-collected samples was observed. CONCLUSION: Self-collection of vaginal samples ensures equity of cervical cancer screening in low-income countries such as India.
Authors: Jenna Los; Charlotte A Gaydos; Cynthia L Gibert; Geoffrey J Gorse; Jacquelyn Lykken; Ann-Christine Nyquist; Connie S Price; Lewis J Radonovich; Susan Rattigan; Nicholas Reich; Maria Rodriguez-Barradas; Michael Simberkoff; Mary Bessesen; Alexandria Brown; Derek A T Cummings; Trish M Perl Journal: Am J Infect Control Date: 2021-02-10 Impact factor: 2.918
Authors: Bernardo Vega Crespo; Vivian Alejandra Neira; José Ortíz Segarra; Ruth Maldonado Rengel; Diana López; María Paz Orellana; Andrea Gómez; María José Vicuña; Jorge Mejía; Ina Benoy; Tesifón Parrón Carreño; Veronique Verhoeven Journal: Int J Environ Res Public Health Date: 2022-04-12 Impact factor: 4.614