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Are vaginal swabs comparable to cervical smears for human papillomavirus DNA testing?

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Abstract
Objective: Human papillomavirus (HPV) testing is widely incorporated into cervical cancer screening strategies. Current screening requires pelvic examination for cervical sampling, which may compromise participation. The acceptance could be raised by introducing testing on vaginal swabs. We explored the interchangeability of vaginal swabs and cervical smears for HPV testing, by means of a prospective study conducted in female sex workers (FSWs). Besides, we report on the occurrence of 32 different HPV genotypes in FSW with low-grade squamous intraepithelial lesion (LSIL) or high-grade squamous intraepithelial lesion (HSIL). Methods: Paired physician-collected vaginal swabs and cervical smears from 303 FSW were tested for HPV using the Abbott RealTime High-Risk HPV assay. Cervical cytology was examined on cervical smears. In case of HSIL/LSIL cytological classification (n=52), both samples were genotyped using INNO-LiPa HPV Genotyping Extra II. Results: The overall prevalence of high-risk (HR)-HPV was 51%. In FSW with HSIL/LSIL cervical cytology, the sensitivity and specificity of vaginal samples for the detection of HRHPV was 100% and 70% and for probable HR-HPV 100% and 91%. The mean number of genotypes identified in vaginal samples (mean=3.5; 95% confidence interval [CI]=2.8-4.2) was significantly higher than in cervical smear samples (mean=2.6; 95% CI=2.1-3.0) (p=0.001). The most frequently encountered HR-HPV genotypes were HPV16, 31, 51, and 52. Conclusion: As our study shows that vaginal swabs are equivalent to cervical smears for the detection of (probable) HR-HPV, vaginal swabs can be used for HPV testing in cervical cancer screening strategies. Given the acceptance of vaginal sampling, this finding offers an opportunity to boost screening coverage.
Keywords
Neisseria Gonorrhoeae, Chlamydia Trachomatis, Papillomaviridae, Trichomonas Vaginalis, Mycoplasma Genitalium, Sexually Transmitted Diseases, FEMALE SEX WORKERS, SEXUALLY-TRANSMITTED INFECTIONS, TRICHOMONAS-VAGINALIS, CHLAMYDIA-TRACHOMATIS, HPV INFECTION, SELF, PREVALENCE, WOMEN, CLINICIAN, METAANALYSIS

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Chicago
Coorevits, Liselotte, Ans Traen, Luc Bingé, Jo Van Dorpe, Marleen Praet, Jerina Boelens, and Elizaveta Padalko. 2018. “Are Vaginal Swabs Comparable to Cervical Smears for Human Papillomavirus DNA Testing?” Journal of Gynecologic Oncology 29 (1).
APA
Coorevits, Liselotte, Traen, A., Bingé, L., Van Dorpe, J., Praet, M., Boelens, J., & Padalko, E. (2018). Are vaginal swabs comparable to cervical smears for human papillomavirus DNA testing? JOURNAL OF GYNECOLOGIC ONCOLOGY, 29(1).
Vancouver
1.
Coorevits L, Traen A, Bingé L, Van Dorpe J, Praet M, Boelens J, et al. Are vaginal swabs comparable to cervical smears for human papillomavirus DNA testing? JOURNAL OF GYNECOLOGIC ONCOLOGY. 2018;29(1).
MLA
Coorevits, Liselotte, Ans Traen, Luc Bingé, et al. “Are Vaginal Swabs Comparable to Cervical Smears for Human Papillomavirus DNA Testing?” JOURNAL OF GYNECOLOGIC ONCOLOGY 29.1 (2018): n. pag. Print.
@article{8552045,
  abstract     = {Objective: Human papillomavirus (HPV) testing is widely incorporated into cervical cancer screening strategies. Current screening requires pelvic examination for cervical sampling, which may compromise participation. The acceptance could be raised by introducing testing on vaginal swabs. We explored the interchangeability of vaginal swabs and cervical smears for HPV testing, by means of a prospective study conducted in female sex workers (FSWs). Besides, we report on the occurrence of 32 different HPV genotypes in FSW with low-grade squamous intraepithelial lesion (LSIL) or high-grade squamous intraepithelial lesion (HSIL). 
Methods: Paired physician-collected vaginal swabs and cervical smears from 303 FSW were tested for HPV using the Abbott RealTime High-Risk HPV assay. Cervical cytology was examined on cervical smears. In case of HSIL/LSIL cytological classification (n=52), both samples were genotyped using INNO-LiPa HPV Genotyping Extra II. 
Results: The overall prevalence of high-risk (HR)-HPV was 51\%. In FSW with HSIL/LSIL cervical cytology, the sensitivity and specificity of vaginal samples for the detection of HRHPV was 100\% and 70\% and for probable HR-HPV 100\% and 91\%. The mean number of genotypes identified in vaginal samples (mean=3.5; 95\% confidence interval [CI]=2.8-4.2) was significantly higher than in cervical smear samples (mean=2.6; 95\% CI=2.1-3.0) (p=0.001). The most frequently encountered HR-HPV genotypes were HPV16, 31, 51, and 52. 
Conclusion: As our study shows that vaginal swabs are equivalent to cervical smears for the detection of (probable) HR-HPV, vaginal swabs can be used for HPV testing in cervical cancer screening strategies. Given the acceptance of vaginal sampling, this finding offers an opportunity to boost screening coverage.},
  articleno    = {e8},
  author       = {Coorevits, Liselotte and Traen, Ans and Bing{\'e}, Luc and Van Dorpe, Jo and Praet, Marleen and Boelens, Jerina and Padalko, Elizaveta},
  issn         = {2005-0380},
  journal      = {JOURNAL OF GYNECOLOGIC ONCOLOGY},
  language     = {eng},
  number       = {1},
  pages        = {11},
  title        = {Are vaginal swabs comparable to cervical smears for human papillomavirus DNA testing?},
  url          = {http://dx.doi.org/10.3802/jgo.2018.29.e8},
  volume       = {29},
  year         = {2018},
}

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