Comparison of HPV Test Results Using Self-collected and Physician-collected Samples for 241 CIN2+ Cases at a Colposcopy Clinic

Abstract

 In Japan, the rate of cervical cancer screening is about 40% and the HPV vaccination rate is about 1%. The incidence of cervical cancer is still high. We examined the accuracy of self-collected HPV tests from 2012 to 2020. The self-collection devices were Delphi screener^® (wet), Evalyn brush^® (dry), Flocked Swabs^® (dry) and Home Smear Kit plus^® (wet). The HPV tests used HC2 or PCR using Cobas4800^®, DPO-Multiplex PCR^® and HPV13^®. A total of 241 CIN2+ cases were examined at our colposcopy clinic from 2012 to 2020, including 170 using HC2 and 71 using PCR. The HPV-positive rate using HC2 was 77.6% (132/170) for self-collection and 91.8% (156/170) for physician-collection, indicating that the sensitivity of self-collection was lower than that of physician-collection. The HPV-positive rate by PCR was 91.5% (65/71) for self-collection and 90.1% (64/71) for physician-collection, with no differences among self-collection devices and PCR methods. However, about 10% of CIN2+ cases were negative in PCR HPV tests using samples collected by physicians. This suggests the need to explain the risk of a false-negative finding in a single HPV test in advance. Non-HPV related gynecological cancers (endometrial cancer and ovarian cancer) are increasing year by year, and comprehensive gynecological cancer screening is required using a HPV test and by cytology and transvaginal ultrasonography. Self-collection HPV tests may be a solution for patients who have not been examined for cervical cancer.