Evaluation of the Performance of Self-sampling Versus Clinician-collected Sampling for Cervical Cancer Screening
Keywords:
Self Sampling, Cervical cancer, pap smearAbstract
Introduction: Regional variations exist in the incidence and mortality rates of cervical cancer, with higher rates observed in low- and middle-income countries (LMICs) compared to high-income countries. This difference can be attributed to the implementation of standardised screening systems in high-income countries. In LMICs, cervical cancer is the second most prevalent cancer and ranks as the third leading cause of cancer-related deaths among women. Importantly, women in LMICs face a higher lifetime risk of developing cervical cancer, estimated at 1.6%, compared to the 0.9% risk observed in high-income countries. The objective of the study was to compare the effectiveness of self-sampling and clinician-collected sampling methods for cervical cancer screening.
Methods: The sample included 100 participants and a total of 200 samples were collected (2 samples from each participant). This cross-sectional study spanned one year, from July 1, 2021, to June 30, 2022. Non-pregnant women aged 30-70 years were recruited as participants. The collected data underwent appropriate statistical analysis.
Results: The study results indicated that 88% of participants tested negative for HPV DNA according to the clinician’s assessment, while 12% tested positive, and none had an inhibition result. In terms of the HPV DNA impression by clinicians, 12% of participants had a positive result, while 88% had a negative result.
Conclusion: The study revealed nearly equal HPV DNA positivity between self-sampling and clinician-collected samples, with significant agreement and high sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).
How to cite this article:
Meena DK, Singh A, Singh RK, Chauhan M. Evaluation of the Performance of Self-sampling Versus Clinician-collected Sampling for Cervical Cancer Screening. J Adv Res Med Sci Tech. 2023;10(1&2):8-17.
References
Pisani P, Bray F, Parkin DM. Estimates of the worldwide prevalence of cancer for 25 sites in the adult population. Int J Cancer. 2002;97(1):72-81. [PubMed] [Google Scholar]
American Cancer Society. Cancer facts and figures 2018. Atlanta: ACS; 2018.
World Health Organization. Comprehensive cervical cancer control: a guide to essential practice. Geneva: WHO; 2006. [Google Scholar]
Miller AB, Nazeer S, Fonn S, Brandup-Lukanow A, Rehman R, Cronje H, Sankaranarayanan R, Koroltchouk V, Syrjanen K, Singer A, Onsrud M. Report on consensus conference on cervical cancer screening and management. Int J Cancer. 2000;86(3):440-7. [PubMed] [Google Scholar]
Aggarwal P, Batra S, Gandhi G, Zutshi V. Comparison of Papanicolaou test with visual detection tests in screening for cervical cancer and developing the optimal strategy for low resource settings. Int J Gynecol Cancer. 2010;20(5):862-8. [PubMed] [Google Scholar]
Sankaranarayanan R, Esmy PO, Rajkumar R, Muwonge R, Swaminathan R, Shanthakumari S, Fayette JM, Cherian J. Effect of visual screening on cervical cancer incidence and mortality in Tamil Nadu, India: a clusterrandomised trial. Lancet. 2007;370(9585):398-406. [PubMed] [Google Scholar]
Gravitt PE, Paul P, Katki HA, Vendantham H, Ramakrishna G, Sudula M, Kalpana B, Ronnett BM, Vijayaraghavan K, Shah KV; CATCH Study Team. Effectiveness of VIA, Pap, and HPV DNA testing in a cervical cancer screening program in a peri-urban community in Andhra Pradesh, India. PLoS One. 2010;5(10):e13711. [PubMed] [Google Scholar]
Cuzick J, Clavel C, Petry KU, Meijer CJ, Hoyer H, Ratnam S, Szarewski A, Birembaut P, Kulasingam S, Sasieni P, Iftner T. Overview of the European and North American studies on HPV testing in primary cervical cancer screening. Int J Cancer. 2006;119(5):1095-101. [PubMed] [Google Scholar]
Arbyn M, Bergeron C, Klinkhamer P, Martin-Hirsch P, Siebers AG, Bulten J. Liquid compared with conventional cervical cytology: a systematic review and meta-analysis. Obstet Gynecol. 2008;111(1):167- 77. [PubMed] [Google Scholar]
Karnon J, Peters J, Platt J, Chilcott J, McGoogan E, Brewer N. Liquid-based cytology in cervical screening: an updated rapid and systematic review and economic analysis. Health Technol Assess. 2004;8(20):1-78. [PubMed] [Google Scholar]
Sowjanya AP, Paul P, Vedantham H, Ramakrishna G, Vidyadhari D, Vijayaraghavan K, Laksmi S, Sudula M, Ronnett BM, Das M, Shah KV, Gravitt PE; Community Access to Cervical Health Study Group. Suitability of self-collected vaginal samples for cervical cancer screening in periurban villages in Andhra Pradesh, India. Cancer Epidemiol Biomarkers Prev. 2009;18(5):1373-8. [PubMed] [Google Scholar]
Arbyn M, Verdoodt F, Snijders PJ, Verhoef VM, Suonio E, Dillner L, Minozzi S, Bellisario C, Banzi R, Zhao FH, Hillemanns P, Anttila A. Accuracy of human papillomavirus testing on self collected versus cliniciancollected samples: a meta-analysis. Lancet Oncol. 2014;15(2):172-83. [PubMed] [Google Scholar]
Mehrotra R, Hariprasad R, Rajaraman P, Mahajan V, Grover R, Kaur P, Swaminathan S. Stemming the wave of cervical cancer: human papillomavirus vaccine introduction in India. J Glob Oncol. 2018;4:1- 4. [PubMed] [Google Scholar]
Sankaranarayanan R, Basu P, Kaur P, Bhaskar R, Singh GB, Denzongpa P, Grover RK, Sebastian P, Saikia T, Oswal K, Kanodia R, Dsouza A, Mehrotra R, Rath GK, Jaggi V, Kashyap S, Kataria I, Hariprasad R, Sasieni P, Bhatla N, Rajaraman P, Trimble EL, Swaminathan S, Purushotham A. Current status of human papillomavirus vaccination in India’s cervical cancer prevention efforts. Lancet Oncol. 2019;20(11):e637-44. [PubMed] [Google Scholar]
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424. [PubMed] [Google Scholar]
World Health Organization [Internet]. Cervical cancer; 2018 [cited 2018 Apr 25]. Available from: http://www. who.int/cancer/prevention/diagnosis-screening/ cervical-cancer/en/
Cibula D, Potter R, Planchamp F, Avall-Lundqvist E, Fischerova D, Haie-Meder C, Köhler C, Landoni F, Lax S, Lindegaard JC, Mahantshetty U, Mathevet P, McCluggage WG, McCormack M, Naik R, Nout R, Pignata S, Ponce J, Querleu D, Raspagliesi F, Rodolakis A, Tamussino K, Wimberger P, Raspollini MR. The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology guidelines for the management of patients with cervical cancer. Virchows Arch. 2018;472(6):919- 36. [PubMed] [Google Scholar]
Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65(2):87-108. [PubMed] [Google Scholar]
Sriplung H, Singkham P, Iamsirithaworn S, Jiraphongsa C, Bilheem S. Success of a cervical cancer screening program: trends in incidence in Songkhla, Southern Thailand, 1989–2010, and prediction of future incidences to 2030. Asian Pac J Cancer Prev. 2014;15(22):10003-8. [PubMed] [Google Scholar]
Olorunfemi G, Ndlovu N, Masukume G, Chikandiwa A, Pisa PT, Singh E. Temporal trends in the epidemiology of cervical cancer in South Africa (1994–2012). Int J Cancer. 2018;143(9):2238-49. [PubMed] [Google Scholar]
Fedewa SA, Cokkinides V, Virgo KS, Bandi P, Saslow D, Ward EM. Association of insurance status and age with cervical cancer stage at diagnosis: National Cancer Database, 2000–2007. Am J Public Health. 2012;102(9):1782-90. [PubMed] [Google Scholar]
UNAIDS [Internet]. The gap report; [cited 2019 Jul 14]. Available from: https://files.unaids.org/ en/media/unaids/contentassets/documents/ unaidspublication/2014/UNAIDS_Gap_report_en.pdf
Moscicki AB, Ellenberg JH, Farhat S, Xu J. Persistence of human papillomavirus infection in HIV-infected and -uninfected adolescent girls: risk factors and differences, by phylogenetic type. J Infect Dis. 2004;190(1):37-45. [PubMed] [Google Scholar]
Ghebre RG, Grover S, Xu MJ, Chuang LT, Simonds H. Cervical cancer control in HIV-infected women: past, present and future. Gynecol Oncol Rep. 2017;21:101-8. [PubMed] [Google Scholar]
