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Pedrão PG, de Carvalho AC, Possati-Resende JC, de Paula Cury F, Campanella NC, de Oliveira CM, Tavares Guerreiro Fregnani JH. DNA Recovery Using Ethanol-Based Liquid Medium from FTA Card-Stored Samples for HPV Detection. Acta Cytol 2021; 65:264-271. [PMID: 33951624 DOI: 10.1159/000515913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 03/09/2021] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Alternative methods of dry storage and transportation may be a viable alternative to the use of liquid storage medium for cervical samples, especially for screening programs in places with few resources. OBJECTIVE The objective of this study is to verify the viability and efficacy of human papillomavirus DNA (HPV-DNA) detection in cervical cell samples collected and stored on a Flinders Technology Associates (FTA) card (Whatman Indicating FTA® Elute Micro Card) and subsequently recovered in ethanol-based liquid medium and to compare the results to those obtained using samples stored directly in ethanol-based liquid medium. STUDY DESIGN Thirty-four women submitted to ETZ (excision of the transformation zone of the cervix) were included in this study. Before ETZ, 2 samples of exfoliated cervical cells were collected from each woman by a doctor and stored in ethanol-based liquid medium and on an FTA card. DNA recovery from FTA samples was performed using ethanol-based liquid medium. Detection of HPV-DNA in the samples was performed using the Cobas® 4800 HPV Test Platform. RESULTS AND CONCLUSIONS The HPV-DNA detection positivity rates were 70.6% for the samples collected directly in liquid medium and 64.7% for the samples stored on the FTA card, with high detection accuracy in the DNA samples recovered from the FTA card (area under the curve = 0.958; 95% confidence interval = 0.890-1.000). The concordance between the results obtained using the 2 storage media was 94.1% (Kappa = 0.866). These preliminary results suggest that collection of cervical material on an FTA card may be an alternative to storage in liquid medium since the liquid medium has some limitations. In addition, DNA recovery from the card using ethanol-based liquid medium streamlines the workflow in the laboratory and reduces the cost associated with reagents, thereby facilitating access to the HPV test in places with few resources and potentially improving cervical cancer screening.
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Affiliation(s)
- Priscila Grecca Pedrão
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | | | | | | | - Nathália C Campanella
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Cristina Mendes de Oliveira
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- DASA Laboratories, São Paulo, Brazil
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Du H, Duan X, Liu Y, Shi B, Zhang W, Wang C, Qu X, Bao J, Li J, Zhao C, Jiang J, Liu J, Wu K, Xiao A, Duan L, Huang X, Bian S, Zhang L, Luo H, Wei L, Belinson JL, Wu R. An evaluation of solid versus liquid transport media for high-risk HPV detection and cervical cancer screening on self-collected specimens. Infect Agent Cancer 2020; 15:72. [PMID: 33292341 PMCID: PMC7706049 DOI: 10.1186/s13027-020-00333-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 10/28/2020] [Indexed: 01/30/2023] Open
Abstract
Background The solid transport media is a small size card that allows fast, easy DNA extraction from a variety of biological samples. In 2016 we developed a solid media transport card; for that pilot study to control the self-collection we used a pseudo-self-collection technique. The current study expands this prior work using true self-collections and only the POI card, and aims to evaluate the solid media transport card to detect HR-HPV in self-samples compared to liquid transport media. Methods Ten thousand eight hundred eighty-five women between the ages of 30–59 with no screening for 3 years were enrolled. The self-collected sample was first applied to a new solid media transport card (Labeled as SC) then the brush placed in 6 ml ThinPrep liquid (Labeled as SL). Then a physician collected a direct endocervical specimen into ThinPrep liquid (Labeled as DL). Samples were tested with Cobas 4800 and the SeqHPV NGS assay for HR-HPV. Patients positive on any test were recalled for colposcopy and biopsy. Results Ten thousand three hundred thirty-nine participants had complete data. The mean age was 43.9 years. CIN 2+ rates were 1.4% (142/10339). The agreement in HPV detection between the two different self-sample collection media was also good (Cobas HPV kappa = 0.86; SeqHPV kappa = 0.98). Tested with Cobas, the sensitivity of Cobas-SL and Cobas-SC for CIN 2+ was95.07 and 94.37%; and for CIN3+ was 96.30, 96.30% respectively. The specificity of Cobas-SC, and Cobas-SL for CIN2+ was 88.74 and 87.35%; for CIN3 was 88.04and 86.65% respectively. Tested with SeqHPV, the sensitivity for CIN2+ of Seq-SC and Seq-SL was 95.77 and 96.48%; for CIN3+, both the SC and SL specimens had a sensitivity of 100%. The specificity for CIN2+ of Seq-SC and Seq-SL was 89.54 and 89.53%; for CIN3+ was 88.84,88.82% respectively. For both HR-HPV assays, the sensitivities were similar for the two self-sample media (SC vs SL, p = 1.00). Conclusions The solid transport card for collecting vaginal self-samples as accurate as liquid transport media assayed by two different PCR based HR-HPV tests. The solid transport media is a suitable medium for collecting and storing vaginal self-samples. Supplementary Information The online version contains supplementary material available at 10.1186/s13027-020-00333-4.
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Affiliation(s)
- Hui Du
- Peking University Shenzhen Hospital, Shenzhen, PR China
| | - Xianzhi Duan
- Capital Medical University Beijing Tongren Hospital, Beijing, PR China
| | - Yan Liu
- Fudan University Huashan Hospital North, Shanghai, PR China
| | - Bin Shi
- The second Hospital of Hebei Medical University, Shijiazhuang, PR China
| | - Wei Zhang
- Wuhan University Zhongnan Hospital, Wuhan, PR China
| | - Chun Wang
- Peking University Shenzhen Hospital, Shenzhen, PR China
| | - Xinfen Qu
- Peking University Shenzhen Hospital, Shenzhen, PR China
| | - Juncui Bao
- Peking University Shenzhen Hospital, Shenzhen, PR China
| | - Jingran Li
- Peking University People's Hospital, Beijing, PR China
| | - Chao Zhao
- Peking University People's Hospital, Beijing, PR China
| | - Jing Jiang
- The second Hospital of Hebei Medical University, Shijiazhuang, PR China
| | - Juan Liu
- Fudan University Huashan Hospital North, Shanghai, PR China
| | - Kejia Wu
- Wuhan University Zhongnan Hospital, Wuhan, PR China
| | - Aimin Xiao
- Peking University Shenzhen Hospital, Shenzhen, PR China
| | - Lvfang Duan
- Peking University Shenzhen Hospital, Shenzhen, PR China
| | - Xia Huang
- Peking University Shenzhen Hospital, Shenzhen, PR China
| | - Shuhuang Bian
- Peking University Shenzhen Hospital, Shenzhen, PR China
| | - Lijie Zhang
- Peking University Shenzhen Hospital, Shenzhen, PR China
| | - Hongxue Luo
- Peking University Shenzhen Hospital, Shenzhen, PR China
| | - Lihui Wei
- Peking University People's Hospital, Beijing, PR China.
| | - Jerome L Belinson
- Preventive Oncology International Inc, and the Cleveland Clinic, Cleveland, OH, USA.
| | - Ruifang Wu
- Peking University Shenzhen Hospital, Shenzhen, PR China.
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Taku O, Meiring TL, Gustavsson I, Phohlo K, Garcia-Jardon M, Mbulawa ZZA, Businge CB, Gyllensten U, Williamson AL. Acceptability of self- collection for human papillomavirus detection in the Eastern Cape, South Africa. PLoS One 2020; 15:e0241781. [PMID: 33170891 PMCID: PMC7654756 DOI: 10.1371/journal.pone.0241781] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 10/20/2020] [Indexed: 12/14/2022] Open
Abstract
Human papillomavirus (HPV) testing on vaginal self-collected and cervical clinician-collected specimens shows comparable performance. Self-sampling on FTA cards is suitable for women residing in rural settings or not attending regular screening and increases participation rate in the cervical cancer screening programme. We aimed to investigate and compare high-risk (HR)-HPV prevalence in clinician-collected and self-collected genital specimens as well as two different HPV tests on the clinician collected samples. A total of 737 women were recruited from two sites, a community health clinic (n = 413) and a referral clinic (n = 324) in the Eastern Cape Province. Cervical clinician-collected (FTA cards and Digene transport medium) and vaginal self-collected specimens were tested for HR-HPV using the hpVIR assay (FTA cards) and Hybrid Capture-2 (Digene transport medium). There was no significant difference in HR-HPV positivity between clinician-collected and self-collected specimens among women from the community-based clinic (26.4% vs 27.9%, p = 0.601) or the referral clinic (83.6% vs 79.9%, p = 0.222). HPV16, HPV35, and HPV33/52/58 group were the most frequently detected genotypes at both study sites. Self-sampling for HPV testing received a high positive response of acceptance (77.2% in the community-based clinic and 83.0% in referral clinic). The overall agreement between hpVIR assay and HC-2 was 87.7% (k = 0.754). The study found good agreement between clinician-collected and self-collected genital specimens. Self-collection can have a positive impact on a cervical screening program in South Africa by increasing coverage of women in rural areas, in particular those unable to visit the clinics and women attending clinics where cytology-based programs are not functioning effectively.
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Affiliation(s)
- Ongeziwe Taku
- Division of Medical Virology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Tracy L. Meiring
- Division of Medical Virology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Inger Gustavsson
- Department of Immunology, Genetics, and Pathology, Biomedical Center, Science for Life Laboratory Uppsala, Uppsala University, Uppsala, Sweden
| | - Keletso Phohlo
- Division of Medical Virology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Mirta Garcia-Jardon
- Department of Pathology at Walter Sisulu University and National Health Laboratory Service, Mthatha, South Africa
| | - Zizipho Z. A. Mbulawa
- Division of Medical Virology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- SAMRC Gynaecological Cancer Research Centre, University of Cape Town, Cape Town, South Africa
- Department of Laboratory Medicine and Pathology, National Health Laboratory Service Nelson Mandela Academic Hospital and Walter Sisulu University, Mthatha, Eastern Cape, South Africa
- Medical Virology, National Health Laboratory Service, Nelson Mandela Academic Hospital, Mthatha, South Africa
| | - Charles B. Businge
- Department of Obstetrics and Gynaecology, Nelson Mandela Academic Hospital, Mthatha, South Africa
- Department of Obstetrics and Gynaecology, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa
| | - Ulf Gyllensten
- Department of Immunology, Genetics, and Pathology, Biomedical Center, Science for Life Laboratory Uppsala, Uppsala University, Uppsala, Sweden
| | - Anna-Lise Williamson
- Division of Medical Virology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
- SAMRC Gynaecological Cancer Research Centre, University of Cape Town, Cape Town, South Africa
- * E-mail:
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Gustavsson I, Aarnio R, Myrnäs M, Hedlund-Lindberg J, Taku O, Meiring T, Wikström I, Enroth S, Williamson AL, Olovsson M, Gyllensten U. Clinical validation of the HPVIR high-risk HPV test on cervical samples according to the international guidelines for human papillomavirus DNA test requirements for cervical cancer screening. Virol J 2019; 16:107. [PMID: 31438976 PMCID: PMC6704622 DOI: 10.1186/s12985-019-1216-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 08/14/2019] [Indexed: 12/18/2022] Open
Abstract
Background The indicating FTA card is a dry medium used for collection of cervical samples. HPVIR is a multiplex real-time PCR test that detects 12 high-risk human papillomavirus types (hrHPV) and provides single genotype information for HPV16, − 31, − 35, − 39, − 51, − 56, and − 59 and pooled type information for HPV18/45 and HPV33/52/58. The aim of this study was to evaluate whether a strategy with cervical samples collected on the FTA card and subsequently analysed with the HPVIR test complies with the criteria of the international guidelines for a clinically validated method for cervical screening. Methods We performed a non-inferiority test comparing the clinical sensitivity and specificity of the candidate test (FTA card and HPVIR) with a clinically validated reference test (Cobas® HPV test) based on liquid-based cytology (LBC) samples. Two clinical samples (LBC and FTA) were collected from 896 participants in population-based screening. For evaluation of the specificity we used 799 women without ≥ CIN2, and for clinical sensitivity we used 67 women with histologically confirmed ≥ CIN2. The reproducibility was studied by performing inter- and intra-laboratory tests of 558 additional clinical samples. Results The clinical sensitivity and specificity for samples collected on the FTA card and analysed using the HPVIR test were non-inferior to samples analysed with the Cobas® HPV test based on LBC samples (non-inferiority test score, p = 1.0 × 10− 2 and p = 1.89 × 10− 9, respectively). Adequate agreement of > 87% was seen in both the intra- and inter-laboratory comparisons. Conclusions Samples collected on the indicating FTA card and analysed with HPVIR test fulfil the requirements of the international guidelines and can therefore be used in primary cervical cancer screening.
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Affiliation(s)
- Inger Gustavsson
- Department of Immunology, Genetics, and Pathology, Biomedical Center, Science for Life Laboratory Uppsala, Uppsala University, Box 815, SE-75108, Uppsala, Sweden
| | - Riina Aarnio
- Department of Women's and Children's Health, Uppsala University, SE-751 85, Uppsala, Sweden
| | - Mattias Myrnäs
- Department of Women's and Children's Health, Uppsala University, SE-751 85, Uppsala, Sweden
| | - Julia Hedlund-Lindberg
- Department of Immunology, Genetics, and Pathology, Biomedical Center, Science for Life Laboratory Uppsala, Uppsala University, Box 815, SE-75108, Uppsala, Sweden
| | - Ongeziwe Taku
- Division of Medical Virology, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925, South Africa
| | - Tracy Meiring
- Division of Medical Virology, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925, South Africa
| | - Ingrid Wikström
- Department of Women's and Children's Health, Uppsala University, SE-751 85, Uppsala, Sweden
| | - Stefan Enroth
- Department of Immunology, Genetics, and Pathology, Biomedical Center, Science for Life Laboratory Uppsala, Uppsala University, Box 815, SE-75108, Uppsala, Sweden
| | - Anna-Lise Williamson
- Division of Medical Virology, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925, South Africa
| | - Matts Olovsson
- Department of Women's and Children's Health, Uppsala University, SE-751 85, Uppsala, Sweden
| | - Ulf Gyllensten
- Department of Immunology, Genetics, and Pathology, Biomedical Center, Science for Life Laboratory Uppsala, Uppsala University, Box 815, SE-75108, Uppsala, Sweden.
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Gaffney DK, Hashibe M, Kepka D, Maurer KA, Werner TL. Too many women are dying from cervix cancer: Problems and solutions. Gynecol Oncol 2018; 151:547-554. [PMID: 30301561 PMCID: PMC6281756 DOI: 10.1016/j.ygyno.2018.10.004] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 09/26/2018] [Accepted: 10/01/2018] [Indexed: 12/29/2022]
Abstract
One woman dies from cervix cancer every 2 min, adding up to over 270,000 deaths globally per year. This cancer affects a young population, and hence, the loss of life is staggering. There are many aspects of prevention, screening, and care that are suboptimal. A great deal is known about HPV induced carcinogenesis, yet clinical outcomes have been stagnant over decades. There has been no improvement in cervix cancer survival in the US since the mid-1970s [1]. With increased knowledge of the disease and greater worldwide resources including prevention, screening, and improved therapeutics, there is significant promise for fewer women to die from this virally induced cancer. We focus here on the major problems in prevention, screening, and delivery of care for cervix cancer and provide concrete solutions. With appropriate focus, a major improvement in survival from cervix cancer could be achieved in a short time span.
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Affiliation(s)
- David K Gaffney
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT 84103, United States of America; Department of Radiation Oncology, University of Utah School of Medicine, 1950 Circle of Hope, Rm 1570, Salt Lake City, UT 84112, United States of America.
| | - Mia Hashibe
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT 84103, United States of America; Division of Public Health, Department of Family and Preventative Medicine, University of Utah School of Medicine, 375 Chipeta Way, Suite. A, Salt Lake City, UT 84108, United States of America
| | - Deanna Kepka
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT 84103, United States of America; College of Nursing, University of Utah, 10 South 2000 East, Salt Lake City, UT 84112, United States of America
| | - Kathryn A Maurer
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT 84103, United States of America; Department of Obstetrics and Gynecology, University of Utah School of Medicine, 30 North 1900 East, Salt Lake City, UT 84132, United States of America
| | - Theresa L Werner
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT 84103, United States of America; Division of Oncology, Department of Medicine, University of Utah School of Medicine, 2000 Circle of Hope, Suite 2100, Salt Lake City, UT 84132, United States of America
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Gustavsson I, Aarnio R, Berggrund M, Hedlund-Lindberg J, Sanner K, Wikström I, Enroth S, Olovsson M, Gyllensten U. Randomised study of HPV prevalence and detection of CIN2+ in vaginal self-sampling compared to cervical specimens collected by medical personnel. Int J Cancer 2018; 144:89-97. [PMID: 29943822 DOI: 10.1002/ijc.31637] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 05/17/2018] [Accepted: 05/30/2018] [Indexed: 12/27/2022]
Abstract
We conducted a randomised study to compare vaginal self-sampling with assisted sampling by medical personnel on the cervix for HPV testing in primary screening. The first aim was to determine if the HPV prevalence is independent of sampling location (vagina versus cervix) and the person performing the sampling. The second aim was to evaluate if the two sampling strategies differed in the detection rate of CIN2+. In total, 19,523 women were randomised into two groups, with 9926 invited to perform self-sampling (SS arm) using the Rover VIBA-brush and 9597 offered assisted sampling using the cytobrush (AS arm). All samples were applied to the indicating FTA elute card and analysed for high-risk HPV using the hpVIR real-time PCR assay. The outcome for the first aim was HPV prevalence and for the second aim the number of CIN2+ based on histology. In the SS arm, 52.7% of invited women participated in the study, as compared to 34.2% in the AS arm. All samples contained sufficient amount of nuclear DNA for a valid HPV result, with vaginal samples having a higher DNA amount than cervical samples (p < 4.62 × 10-11 ). HPV prevalence was 4.6% in the SS arm and 4.1% in the AS arm (p = 5.5 × 10-2 ), and the distribution of HPV types similar between arms. There was no difference in the prevalence of CIN2+ per 1000 women screened between arms (p = 0.86). The results show that vaginal self-sampling is an equivalent alternative to sampling by medical personnel for HPV typing and identification of CIN2+.
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Affiliation(s)
- Inger Gustavsson
- Department of Immunology, Genetics, and Pathology, Biomedical Center, Science for Life Laboratory Uppsala, Uppsala University, Uppsala, Sweden
| | - Riina Aarnio
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Malin Berggrund
- Department of Immunology, Genetics, and Pathology, Biomedical Center, Science for Life Laboratory Uppsala, Uppsala University, Uppsala, Sweden
| | - Julia Hedlund-Lindberg
- Department of Immunology, Genetics, and Pathology, Biomedical Center, Science for Life Laboratory Uppsala, Uppsala University, Uppsala, Sweden
| | - Karin Sanner
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Ingrid Wikström
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Stefan Enroth
- Department of Immunology, Genetics, and Pathology, Biomedical Center, Science for Life Laboratory Uppsala, Uppsala University, Uppsala, Sweden
| | - Matts Olovsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Ulf Gyllensten
- Department of Immunology, Genetics, and Pathology, Biomedical Center, Science for Life Laboratory Uppsala, Uppsala University, Uppsala, Sweden
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Randomised study shows that repeated self-sampling and HPV test has more than two-fold higher detection rate of women with CIN2+ histology than Pap smear cytology. Br J Cancer 2018; 118:896-904. [PMID: 29438367 PMCID: PMC5886121 DOI: 10.1038/bjc.2017.485] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 12/11/2017] [Accepted: 12/13/2017] [Indexed: 11/08/2022] Open
Abstract
This corrects the article DOI: 10.1038/bjc.2017.85.
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Smith JS, Des Marais AC, Deal AM, Richman AR, Perez-Heydrich C, Yen-Lieberman B, Barclay L, Belinson J, Rinas A, Brewer NT. Mailed Human Papillomavirus Self-Collection With Papanicolaou Test Referral for Infrequently Screened Women in the United States. Sex Transm Dis 2018; 45:42-48. [PMID: 28876298 PMCID: PMC5846187 DOI: 10.1097/olq.0000000000000681] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Testing for high-risk human papillomavirus (HPV) infection using mailed, self-collected samples is a promising approach to increase screening in women who do not attend clinic screening at recommended intervals. METHODS To assess this intervention among high-risk women in the United States, 429 women without a Papanicolaou (Pap) test in 4 or more years (overdue by US guidelines) were recruited from the general population. Participants aged 30 to 65 years were mailed a kit to self-collect a cervicovaginal sample at home, return the sample by mail, and receive HPV results by telephone, with referral to follow-up cytological Pap testing at a local clinic. Cervicovaginal self-samples were collected with a Viba brush, stored in Scope mouthwash, and tested by Hybrid Capture 2. Data were collected in 2010 to 2011 and analyzed in 2017. RESULTS Two-thirds (64%) of participants returned a self-collected sample, of whom 15% tested HPV DNA positive. Human papillomavirus self-test-positive women reported higher rates of follow-up Pap tests (82%) than did those with self-test negative results (51%). No demographic differences were found in self-test return rate or HPV positivity. High acceptability was reported in participant surveys: most women (81%) had "mostly positive" overall thoughts about the self-test, and most reported being comfortable receiving the kit in the mail (99%), returning their self-collected sample by mail (82%), and receiving their test results by telephone (97%). CONCLUSIONS Conducting HPV self-testing through population-based recruitment, mailed kit delivery and return by mail, and results delivery by telephone has the potential to reach a broad segment of US underscreened women.
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Surriabre P, Allende G, Prado M, Cáceres L, Bellot D, Torrico A, Ustariz K, Rojas S, Barriga J, Calle P, Villarroel L, Yañez RM, Baay M, Rodriguez P, Fontaine V. Self-sampling for human papillomavirus DNA detection: a preliminary study of compliance and feasibility in BOLIVIA. BMC Womens Health 2017; 17:135. [PMID: 29273032 PMCID: PMC5741906 DOI: 10.1186/s12905-017-0490-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 11/30/2017] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND Cervical cancer incidence and mortality rates in Bolivia are among the highest in Latin America. This investigation aims to evaluate the possibility of using simple devices, e.g. a cotton swab and a glass slide, for self-sampling in order to detect human papillomavirus (HPV) DNA by PCR in cervico-vaginal cells. METHODS In the first phase of our study we evaluated the use of a glass slide as a transport medium for cervical cells. A physician took paired-cervical samples from 235 women. One sample was transported in Easyfix® solution and the other sample was smeared over a glass slide. Both were further analyzed and compared for human DNA recovery and HPV detection. A kappa value was determined to evaluate the agreement between the HPV DNA detection rates. In the second phase of the study, 222 women from the urban, peri-urban and rural regions of Cochabamba were requested to perform self-sampling using the following devices: a cotton swab combined with a glass slide, and a vaginal tampon. Women gave their opinion about the self-sampling technique. Finally, the agreement for high risk-HPV detection between self- and physician-collected samples was performed in 201 samples in order to evaluate the self-sampling technique. RESULTS Firstly, the comparison between Easyfix® solution and the glass slide to transport clinical samples gave a good agreement for HPV DNA detection (κ = 0.71, 95% CI 0.60-0.81). Secondly, self-sampling, especially with cotton swab combined with glass slide, would generally be preferred over clinician sampling for a screening program based on HPV detection. Finally, we showed a good agreement between self- and physician collected samples for high risk-HPV detection (κ = 0.71, 95% CI 0.55-0.88). CONCLUSIONS Simple devices such as a cotton swab and a glass slide can be used to perform self-sampling and HPV DNA detection. Furthermore, most Bolivian women preferred self-sampling over clinician-sampling for cervical cancer screening.
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Affiliation(s)
- Pedro Surriabre
- Laboratorio de Virología, Facultad de Medicina, Universidad Mayor de San Simón, Cochabamba, Bolivia
- Unité de Microbiologie Pharmaceutique et Hygiène, Faculté de Pharmacie, Université Libre de Bruxelles, Brussels, Belgium
| | - Gustavo Allende
- Laboratorio de Virología, Facultad de Medicina, Universidad Mayor de San Simón, Cochabamba, Bolivia
- Unité de Microbiologie Pharmaceutique et Hygiène, Faculté de Pharmacie, Université Libre de Bruxelles, Brussels, Belgium
| | - Marcela Prado
- Laboratorio de Virología, Facultad de Medicina, Universidad Mayor de San Simón, Cochabamba, Bolivia
| | - Leyddy Cáceres
- Laboratorio de Virología, Facultad de Medicina, Universidad Mayor de San Simón, Cochabamba, Bolivia
| | - Diego Bellot
- Laboratorio de Virología, Facultad de Medicina, Universidad Mayor de San Simón, Cochabamba, Bolivia
| | - Andrea Torrico
- Laboratorio de Virología, Facultad de Medicina, Universidad Mayor de San Simón, Cochabamba, Bolivia
| | - Karina Ustariz
- Laboratorio de Virología, Facultad de Medicina, Universidad Mayor de San Simón, Cochabamba, Bolivia
| | - Shirley Rojas
- Laboratorio de Virología, Facultad de Medicina, Universidad Mayor de San Simón, Cochabamba, Bolivia
| | - Jaime Barriga
- Hospital Materno Infantil Germán Urquidi, Servicio de Ginecología, Cochabamba, Bolivia
| | - Pamela Calle
- Laboratorio de Virología, Facultad de Medicina, Universidad Mayor de San Simón, Cochabamba, Bolivia
| | - Ligia Villarroel
- Marie Stopes International, Servicio de Ginecología, Cochabamba, Bolivia
| | - Rosse Mary Yañez
- Laboratorio de Virología, Facultad de Medicina, Universidad Mayor de San Simón, Cochabamba, Bolivia
| | - Marc Baay
- Laboratory of Cancer Research and Clinical Oncology, University of Antwerpen, Wilrijk, Belgium
| | - Patricia Rodriguez
- Laboratorio de Virología, Facultad de Medicina, Universidad Mayor de San Simón, Cochabamba, Bolivia
| | - Véronique Fontaine
- Unité de Microbiologie Pharmaceutique et Hygiène, Faculté de Pharmacie, Université Libre de Bruxelles, Brussels, Belgium
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10
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Leinonen MK, Schee K, Jonassen CM, Lie AK, Nystrand CF, Rangberg A, Furre IE, Johansson MJ, Tropé A, Sjøborg KD, Castle PE, Nygård M. Safety and acceptability of human papillomavirus testing of self-collected specimens: A methodologic study of the impact of collection devices and HPV assays on sensitivity for cervical cancer and high-grade lesions. J Clin Virol 2017; 99-100:22-30. [PMID: 29289814 DOI: 10.1016/j.jcv.2017.12.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 12/08/2017] [Accepted: 12/15/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND Comparative data on different self-collection methods is limited. OBJECTIVES To assess the impact of hrHPV testing of two self-collection devices for detection of cervical carcinoma and high-grade lesions. STUDY DESIGN Three hundred ten patients collected two cervicovaginal specimens using a brush (Evalyn®Brush) and a swab (FLOQSwabs™), and filled a questionnaire at home. Then, a physician at the clinic took a cervical specimen into PreservCyt® buffer for hrHPV testing and cytology. All specimens were tested using Anyplex™ II HPV28, Cobas® 4800 HPV Test and Xpert®HPV. RESULTS Performance comparison included 45 cervical carcinomas and 187 patients with premalignant lesions. Compared to the physician-specimen, hrHPV testing of Evalyn®Brush showed non-inferior sensitivity for CIN3+ (relative sensitivity of Anyplex™ 0.99; Cobas® 0.96; Xpert®HPV 0.97) while hrHPV testing of FLOQSwabs™ showed inferior sensitivity (relative sensitivity of Anyplex™ 0.91; Cobas® 0.92; Xpert®HPV 0.93). Similar results were observed for invasive carcinomas albeit that FLOQSwabs™ was statistically non-inferior to the physician-specimen. Self-collection by either Evalyn®Brush or FLOQSwabs™ was more sensitive for CIN3+ than LSIL or worse cytology. Significant decrease in sensitivity for CIN3+ were observed for FLOQSwabs™ when specimens were preprocessed for hrHPV testing after 28 days. Both devices were well accepted, but patients considered Evalyn®Brush easier and more comfortable than FLOQSwabs™. CONCLUSIONS Self-collection is comparable to current screening practice for detecting cervical carcinoma and CIN3+ but device and specimen processing effects exist. Only validated procedure including collection device, hrHPV assay and specimen preparation should be used.
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Affiliation(s)
- Maarit K Leinonen
- Department of Research, Cancer Registry of Norway, 0379 Oslo, Norway.
| | - Kristina Schee
- Department of Research, Cancer Registry of Norway, 0379 Oslo, Norway
| | - Christine M Jonassen
- Center for Laboratory Medicine, Østfold Hospital Trust, 1714 Grålum, Norway; Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, 1432 Ås, Norway
| | - A Kathrine Lie
- Center for Laboratory Medicine, Østfold Hospital Trust, 1714 Grålum, Norway
| | - Camilla F Nystrand
- Center for Laboratory Medicine, Østfold Hospital Trust, 1714 Grålum, Norway
| | - Anbjørg Rangberg
- Center for Laboratory Medicine, Østfold Hospital Trust, 1714 Grålum, Norway
| | - Ingegerd E Furre
- Department of Pathology, Oslo University Hospital, 0379 Oslo, Norway
| | | | - Ameli Tropé
- Department of Cervical Cancer Screening, Cancer Registry of Norway, 0379 Oslo, Norway; Department of Gynecologic Cancer, Division of Cancer Medicine, Oslo University Hospital, 0379 Oslo, Norway
| | - Katrine D Sjøborg
- Department of Obstetrics and Gynaecology, Østfold Hospital Trust, 1714 Grålum, Norway
| | - Philip E Castle
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Mari Nygård
- Department of Research, Cancer Registry of Norway, 0379 Oslo, Norway
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11
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Mbatha JN, Galappaththi-Arachchige HN, Mtshali A, Taylor M, Ndhlovu PD, Kjetland EF, Baay MFD, Mkhize-Kwitshana ZL. Self-sampling for human papillomavirus testing among rural young women of KwaZulu-Natal, South Africa. BMC Res Notes 2017; 10:702. [PMID: 29208043 PMCID: PMC5717820 DOI: 10.1186/s13104-017-3045-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 11/30/2017] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Cervical cancer is a major problem in women and it is important to find a suitable and acceptable screening method, especially among young in low-resource areas for future human papillomavirus (HPV) vaccine follow-up investigations. The study sought to test the acceptability of self-sampling as well as the suitability of the specimen collecting devices. METHODS Ninety-eight young women from rural KwaZulu-Natal were enrolled between March and July 2014. Collected genital specimens were transferred to colour indicator cards for HPV detection. Participants answered a questionnaire where they described their experiences with self-sampling. Samples were tested for high-risk HPV using GP5/6+ PCR. RESULTS Of the enrolled participants, 91 answered questionnaires and indicated that self-sampling was preferred by 51/91 (56%) women while 40/91 (44%) indicated preference for sampling by a doctor (p = 0.023). The majority, 64% were comfortable using a swab, 22% preferred a brush while 11% were comfortable with both devices. Of the 98 self-sampled specimens 61 were negative for HPV in both specimens while 37 were HPV-positive in either brush or swab. Of the 37, 26 (70%) were HPV-positive in both brush and swab (kappa = 0.743) and 11 (30%) were discordant. CONCLUSIONS Self-sampling was acceptable to the majority of participants in this rural area. The Dacron swab was the preferred device, and can be used in combination with colour indicator cards for comfortable self-sampling, easy storage and transport of specimens plus detection.
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Affiliation(s)
- J N Mbatha
- School Laboratory Medicine and Medical Science, University of KwaZulu-Natal, Durban, South Africa. .,Department of Biomedical and Clinical Technology, Durban University of Technology, PO Box 1334, Durban, 4000, South Africa.
| | - H N Galappaththi-Arachchige
- Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - A Mtshali
- School Laboratory Medicine and Medical Science, University of KwaZulu-Natal, Durban, South Africa
| | - M Taylor
- Discipline of Public Health, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - P D Ndhlovu
- Claybrook Center, Imperial College London, London, UK
| | - E F Kjetland
- Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway.,Discipline of Public Health, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - M F D Baay
- Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway.,Laboratory of Cancer Research and Clinical Oncology, University of Antwerp, Antwerp, Belgium
| | - Z L Mkhize-Kwitshana
- School Laboratory Medicine and Medical Science, University of KwaZulu-Natal, Durban, South Africa.,Department of Biomedical Sciences, Mangosuthu University of Technology, Durban, South Africa
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12
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Van Ostade X, Dom M, Tjalma W, Van Raemdonck G. Candidate biomarkers in the cervical vaginal fluid for the (self-)diagnosis of cervical precancer. Arch Gynecol Obstet 2017; 297:295-311. [PMID: 29143101 PMCID: PMC5778162 DOI: 10.1007/s00404-017-4587-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 11/06/2017] [Indexed: 11/29/2022]
Abstract
Purpose Despite improvement in vaccines against human papilloma virus (HPV), the causative agent of cervical cancer, screening women for cervical precancer will remain indispensable in the coming 30–40 years. A simple test that could be performed at home or at a doctor’s practice and that informs the woman whether she is at risk would significantly help make a broader group of patients who aware that they need medical treatment. Cervical vaginal fluid (CVF) is a body fluid that is very well suited for such a test. Methods Narrative review of cervical (pre)cancer candidate biomarkers from cervicovaginal fluid, is based on a detailed review of the literature. We will also discuss the possibilities that these biomarkers create for the development of a self-test or point-of-care test for cervical (pre)cancer. Results Several DNA, DNA methylation, miRNA, and protein biomarkers were identified in the cervical vaginal fluid; however, not all of these biomarkers are suited for development of a simple diagnostic assay. Conclusions Proteins, especially alpha-actinin-4, are most suited for development of a simple assay for cervical (pre)cancer. Accuracy of the test could further be improved by combination of several proteins or by combination with a new type of biomarker, e.g., originating from the cervicovaginal microbiome or metabolome.
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Affiliation(s)
- Xaveer Van Ostade
- Laboratory of Protein Science, Proteomics and Epigenetic Signaling (PPES), University of Antwerp, Wilrijk, Belgium. .,Centre for Proteomics (CfP), University of Antwerp, Wilrijk, Belgium.
| | - Martin Dom
- Laboratory of Protein Science, Proteomics and Epigenetic Signaling (PPES), University of Antwerp, Wilrijk, Belgium.,Centre for Proteomics (CfP), University of Antwerp, Wilrijk, Belgium
| | - Wiebren Tjalma
- Gynecological Oncology Unit, Department of Obstetrics and Gynecology, Multidisciplinary Breast Clinic, Antwerp University Hospital, University of Antwerp, Edegem, Belgium
| | - Geert Van Raemdonck
- Laboratory of Protein Science, Proteomics and Epigenetic Signaling (PPES), University of Antwerp, Wilrijk, Belgium.,Centre for Proteomics (CfP), University of Antwerp, Wilrijk, Belgium
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13
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Dong L, Lin C, Li L, Wang M, Cui J, Feng R, Liu B, Wu Z, Lian J, Liao G, Chen W, Qiao Y. An evaluation of clinical performance of FTA cards for HPV 16/18 detection using cobas 4800 HPV Test compared to dry swab and liquid medium. J Clin Virol 2017; 94:67-71. [DOI: 10.1016/j.jcv.2017.06.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 05/25/2017] [Accepted: 06/25/2017] [Indexed: 10/19/2022]
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14
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Peluso AL, Cozzolino I, Bottiglieri A, Lucchese L, Di Crescenzo RM, Langella M, Selleri C, Zeppa P. Immunoglobulin heavy and light chains and T-cell receptor beta and gamma chains PCR assessment on cytological samples. A study comparing FTA cards and cryopreserved lymph node fine-needle cytology. Cytopathology 2016; 28:203-215. [DOI: 10.1111/cyt.12402] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2016] [Indexed: 01/14/2023]
Affiliation(s)
- A. L. Peluso
- Anatomia Patologica; University of Salerno; Salerno Italy
- DEA; University “G. Marconi” of Rome; Rome
| | - I. Cozzolino
- Department of Public Health; University of Naples ‘Federico II’; Naples Italy
| | - A. Bottiglieri
- Anatomia Patologica; University of Salerno; Salerno Italy
| | - L. Lucchese
- Anatomia Patologica; University of Salerno; Salerno Italy
| | - R. M. Di Crescenzo
- Department of Public Health; University of Naples ‘Federico II’; Naples Italy
| | - M. Langella
- UOC Haematology and Transplantation; AOU San Giovanni di Dio e Ruggi D’Aragona; Salerno Italy
| | - C. Selleri
- Department of Medicine and Surgery; University of Salerno; Salerno Italy
| | - P. Zeppa
- Anatomia Patologica; University of Salerno; Salerno Italy
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15
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Qin Y, Zhang H, Marlowe N, Fei M, Yu J, Lei X, Yu L, Zhang J, Cao D, Ma L, Chen W. Evaluation of human papillomavirus detection by Abbott m2000 system on samples collected by FTA Elute™ Card in a Chinese HIV-1 positive population. J Clin Virol 2016; 85:80-85. [PMID: 27846440 DOI: 10.1016/j.jcv.2016.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 10/28/2016] [Accepted: 11/06/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND HIV+/AIDS women have an increased risk of developing into CIN and cervical cancer compared to the general population. Limited medical resource and the lack of AIDS relevant knowledge impair the coverage and efficiency of cervical cancer screening. OBJECTIVES To compare the clinical performance of self-collected dry storage medium (FTA Elute card) and physician-collected PreservCyt medium in detection of high risk human papillomavirus (HR HPV) among HIV-1 positive population. METHODS Three hundred HIV-1 positive women (aged 25-65) were recruited from Yunnan infectious hospital. Two cervicovaginal samples were collected from each participant: one was collected by the women themselves and applied on a FTA Elute card; the other one was collected by a physician and stored in PreservCyt solution. All the samples were tested for 14 HR HPV using Abbott RealTime High Risk HPV assay. Biopsies were taken for histological diagnosis if any abnormal impression was noticed under colposcopy. RESULTS 291 (97.0%) of participants were eligible for this study. 101 (34.70%) participants were found HR HPV positive in both FTA card and PreservCyt samples, and 19 (6.53%) women were diagnosed as CIN2+. The HR HPV positive rate on samples collected by FTA Elute card and PreservCyt solution was 42.61% and 39.86%, respectively. The overall agreement was 87% (kappa=0.731) between FTA card and PreservCyt. The clinical sensitivity and specificity of FTA card and PreservCyt were 100%, 61.39% and 100%, 64.33%, respectively. CONCLUSIONS In this study, FTA Elute card demonstrated a good performance on self-collected sample for HR HPV detection in HIV-1 positive population. For the women from low-resource area with HIV-1 infection, FTA Elute card could be an attractive sample collection method for cervical cancer screening.
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Affiliation(s)
- Yu Qin
- Department of Epidemiology, Public Health College, Dalian Medical University, Dalian, Liaoning Province, China
| | - Hongyun Zhang
- Gynecology Department, the First Affiliated Hospital, Kunming Medical College, Kunming, Yunnan Province, China
| | - Natalia Marlowe
- Research and Development Department, Abbott Molecular, Des Plaines, USA
| | - Mandong Fei
- Department of Epidemiology, National Cancer Center, Cancer Hospital & Chinese Academy of Medical Sciences, Beijing, China
| | - Judy Yu
- Research and Development Department, Abbott Molecular, Des Plaines, USA
| | - Xiaoqin Lei
- Department of Epidemiology, National Cancer Center, Cancer Hospital & Chinese Academy of Medical Sciences, Beijing, China
| | - Lulu Yu
- Department of Epidemiology, National Cancer Center, Cancer Hospital & Chinese Academy of Medical Sciences, Beijing, China
| | - Jia Zhang
- Department of Epidemiology, National Cancer Center, Cancer Hospital & Chinese Academy of Medical Sciences, Beijing, China
| | - Di Cao
- Research and Development Department, Abbott Molecular, Des Plaines, USA
| | - Li Ma
- Department of Epidemiology, Public Health College, Dalian Medical University, Dalian, Liaoning Province, China
| | - Wen Chen
- Department of Epidemiology, National Cancer Center, Cancer Hospital & Chinese Academy of Medical Sciences, Beijing, China.
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16
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Chen K, Ouyang Y, Hillemanns P, Jentschke M. Excellent analytical and clinical performance of a dry self-sampling device for human papillomavirus detection in an urban Chinese referral population. J Obstet Gynaecol Res 2016; 42:1839-1845. [DOI: 10.1111/jog.13132] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 07/05/2016] [Accepted: 07/18/2016] [Indexed: 10/21/2022]
Affiliation(s)
- KeWei Chen
- Department of Gynaecology and Obstetrics; Hannover Medical School; Hannover Germany
- Department of Gynaecology and Obstetrics, Tongji Hospital; Tongji University; Shanghai China
| | - YiQin Ouyang
- Department of Gynaecology and Obstetrics, Tongji Hospital; Tongji University; Shanghai China
| | - Peter Hillemanns
- Department of Gynaecology and Obstetrics; Hannover Medical School; Hannover Germany
| | - Matthias Jentschke
- Department of Gynaecology and Obstetrics; Hannover Medical School; Hannover Germany
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17
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Barth H, Morel A, Mougin C, Averous G, Legrain M, Fender M, Risch S, Fafi-Kremer S, Velten M, Oudet P, Baldauf JJ, Stoll-Keller F. Long-term storage and safe retrieval of human papillomavirus DNA using FTA elute cards. J Virol Methods 2016; 229:60-5. [DOI: 10.1016/j.jviromet.2015.12.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 12/14/2015] [Accepted: 12/19/2015] [Indexed: 11/29/2022]
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18
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Luo H, Du H, Maurer K, Belinson JL, Wang G, Liu Z, Zhang L, Zhou Y, Wang C, Tang J, Qu X, Wu R. An Evaluation of the Cobas4800 HPV Test on Cervico-Vaginal Specimens in Liquid versus Solid Transport Media. PLoS One 2016; 11:e0148168. [PMID: 26828360 PMCID: PMC4734716 DOI: 10.1371/journal.pone.0148168] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 01/13/2016] [Indexed: 11/25/2022] Open
Abstract
Objectives Determine the ability of the Cobas 4800 assay to detect high-risk human papillomavirus (HrHPV) and high-grade cervical lesions when using cervico-vaginal samples applied to liquid medium and solid media cards compared to a direct cervical sample. Methods Two cervico-vaginal specimens (pseudo self-collected) were obtained from 319 women. One was applied to an iFTA Card (FTA) then the brush placed in liquid-based medium (LSELF); the other was applied to a new solid media: POI card (POI). The clinical performance of Cobas4800 assay using the three aforementioned specimens was compared to direct collected endocervical specimens in liquid media (LDOC). Results The overall agreements of HrHPV detection were 84.2% (LSELF vs. LDOC), 81.0% (FTA vs. LDOC), and 82.3% (POI vs. LDOC). LSELF, FTA and POI identified 98.0%, 79.6%, and 97.5% positive cases of LDOC. Sensitivity to identify CIN2+ were 98.4% (LSELF), 73.8% (FTA), 95.1% (POI), and 93.4% (LDOC) respectively. FTA had 78.1% and 90.4% agreement with the LSELF samples for all HrHPV and HPV16/18 detection respectively, while POI had 91.6% for both. Conclusions Cobas4800 HPV test combined with cervico-vaginal specimens applied to both liquid media and POI solid card are accurate to detect HrHPV infection and high-grade cervical lesions as compared with direct endocervical samples in liquid media.
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Affiliation(s)
- Hongxue Luo
- Department of obstetrics/gynaecology, Peking University Shenzhen Hospital, Shenzhen, PR China
- Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological diseases, Shenzhen, PR China
| | - Hui Du
- Department of obstetrics/gynaecology, Peking University Shenzhen Hospital, Shenzhen, PR China
- Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological diseases, Shenzhen, PR China
| | - Kathryn Maurer
- Gynecologic Oncology Division, Women’s Health Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Jerome L. Belinson
- Gynecologic Oncology Division, Women’s Health Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
- Preventive Oncology International, Cleveland Heights, Ohio, United States of America
| | - Guixiang Wang
- Department of obstetrics/gynaecology, Peking University Shenzhen Hospital, Shenzhen, PR China
- Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological diseases, Shenzhen, PR China
| | - Zhihong Liu
- Department of obstetrics/gynaecology, Peking University Shenzhen Hospital, Shenzhen, PR China
- Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological diseases, Shenzhen, PR China
| | - Lijie Zhang
- Department of obstetrics/gynaecology, Peking University Shenzhen Hospital, Shenzhen, PR China
- Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological diseases, Shenzhen, PR China
| | - Yanqiu Zhou
- Department of obstetrics/gynaecology, Peking University Shenzhen Hospital, Shenzhen, PR China
- Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological diseases, Shenzhen, PR China
| | - Chun Wang
- Department of obstetrics/gynaecology, Peking University Shenzhen Hospital, Shenzhen, PR China
- Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological diseases, Shenzhen, PR China
| | - Jinlong Tang
- Department of obstetrics/gynaecology, Peking University Shenzhen Hospital, Shenzhen, PR China
- Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological diseases, Shenzhen, PR China
| | - Xinfeng Qu
- Preventive Oncology International, Cleveland Heights, Ohio, United States of America
| | - Ruifang Wu
- Department of obstetrics/gynaecology, Peking University Shenzhen Hospital, Shenzhen, PR China
- Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological diseases, Shenzhen, PR China
- * E-mail:
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19
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Maurer K, Luo H, Shen Z, Wang G, Du H, Wang C, Liu X, Wang X, Qu X, Wu R, Belinson J. Evaluation of a new solid media specimen transport card for high risk HPV detection and cervical cancer prevention. J Clin Virol 2016; 76:14-9. [PMID: 26774544 DOI: 10.1016/j.jcv.2015.12.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 12/17/2015] [Accepted: 12/29/2015] [Indexed: 12/18/2022]
Abstract
BACKGROUND Solid media transport can be used to design adaptable cervical cancer screening programs but currently is limited by one card with published data. OBJECTIVE To develop and evaluate a solid media transport card for use in high-risk human papillomavirus detection (HR-HPV). STUDY DESIGN The Preventative Oncology International (POI) card was constructed using PK 226 paper(®) treated with cell-lysing solution and indicating dye. Vaginal samples were applied to the POI card and the indicating FTA (iFTA) elute card. A cervical sample was placed in liquid media. All specimens were tested for HR-HPV. Color change was assessed at sample application and at card processing. Stability of the POI card and iFTA elute card was tested at humidity. RESULTS 319 women were enrolled. Twelve women had at least one insufficient sample with no difference between media (p=0.36). Compared to liquid samples, there was good agreement for HR-HPV detection with kappa of 0.81 (95% CI 0.74-0.88) and 0.71 (95% CI 0.62-0.79) for the POI and iFTA elute card respectively. Sensitivity for ≥CIN2 was 100% (CI 100-100%), 95.1% (CI 92.7-97.6%), and 93.5% (CI 90.7-96.3%) for the HR-HPV test from the liquid media, POI card, and iFTA elute card respectively. There was no color change of the POI card noted in humidity but the iFTA elute card changed color at 90% humidity. CONCLUSIONS The POI card is suitable for DNA transport and HR-HPV testing. This card has the potential to make cervical cancer screening programs more affordable worldwide.
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Affiliation(s)
- Kathryn Maurer
- Gynecologic Oncology Division, Women's Health Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - Hongxue Luo
- Department of Ob/Gyn, Peking University Shenzhen Hospital, Shenzhen, PR China
| | - Zhiyong Shen
- Hyde Biomedical Corporation, Wuhu City, Anhui, PR China
| | - Guixiang Wang
- Department of Ob/Gyn, Peking University Shenzhen Hospital, Shenzhen, PR China
| | - Hui Du
- Department of Ob/Gyn, Peking University Shenzhen Hospital, Shenzhen, PR China
| | - Chun Wang
- Department of Ob/Gyn, Peking University Shenzhen Hospital, Shenzhen, PR China
| | - Xiaobo Liu
- Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Xiamen Wang
- BGI Clinical Laboratories, Shenzhen, PR China
| | - Xinfeng Qu
- BGI Clinical Laboratories, Shenzhen, PR China; Preventive Oncology International, Cleveland Heights, OH, USA
| | - Ruifang Wu
- Department of Ob/Gyn, Peking University Shenzhen Hospital, Shenzhen, PR China
| | - Jerome Belinson
- Gynecologic Oncology Division, Women's Health Institute, Cleveland Clinic, Cleveland, OH, USA; Preventive Oncology International, Cleveland Heights, OH, USA
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20
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Catarino R, Vassilakos P, Bilancioni A, Vanden Eynde M, Meyer-Hamme U, Menoud PA, Guerry F, Petignat P. Randomized Comparison of Two Vaginal Self-Sampling Methods for Human Papillomavirus Detection: Dry Swab versus FTA Cartridge. PLoS One 2015; 10:e0143644. [PMID: 26630353 PMCID: PMC4668032 DOI: 10.1371/journal.pone.0143644] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 11/05/2015] [Indexed: 12/04/2022] Open
Abstract
Background Human papillomavirus (HPV) self-sampling (self-HPV) is valuable in cervical cancer screening. HPV testing is usually performed on physician-collected cervical smears stored in liquid-based medium. Dry filters and swabs are an alternative. We evaluated the adequacy of self-HPV using two dry storage and transport devices, the FTA cartridge and swab. Methods A total of 130 women performed two consecutive self-HPV samples. Randomization determined which of the two tests was performed first: self-HPV using dry swabs (s-DRY) or vaginal specimen collection using a cytobrush applied to an FTA cartridge (s-FTA). After self-HPV, a physician collected a cervical sample using liquid-based medium (Dr-WET). HPV types were identified by real-time PCR. Agreement between collection methods was measured using the kappa statistic. Results HPV prevalence for high-risk types was 62.3% (95%CI: 53.7–70.2) detected by s-DRY, 56.2% (95%CI: 47.6–64.4) by Dr-WET, and 54.6% (95%CI: 46.1–62.9) by s-FTA. There was overall agreement of 70.8% between s-FTA and s-DRY samples (kappa = 0.34), and of 82.3% between self-HPV and Dr-WET samples (kappa = 0.56). Detection sensitivities for low-grade squamous intraepithelial lesion or worse (LSIL+) were: 64.0% (95%CI: 44.5–79.8) for s-FTA, 84.6% (95%CI: 66.5–93.9) for s-DRY, and 76.9% (95%CI: 58.0–89.0) for Dr-WET. The preferred self-collection method among patients was s-DRY (40.8% vs. 15.4%). Regarding costs, FTA card was five times more expensive than the swab (~5 US dollars (USD)/per card vs. ~1 USD/per swab). Conclusion Self-HPV using dry swabs is sensitive for detecting LSIL+ and less expensive than s-FTA. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN): 43310942
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Affiliation(s)
- Rosa Catarino
- Division of Gynecology, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- * E-mail:
| | - Pierre Vassilakos
- Geneva Foundation for Medical Education and Research, Geneva, Switzerland
| | - Aline Bilancioni
- Division of Gynecology, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Mathieu Vanden Eynde
- Division of Gynecology, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Ulrike Meyer-Hamme
- Division of Gynecology, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | | | | | - Patrick Petignat
- Division of Gynecology, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
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Wang SM, Hu SY, Chen W, Chen F, Zhao FH, He W, Ma XM, Zhang YQ, Wang J, Sivasubramaniam P, Qiao YL. Feasibility and accuracy evaluation of three human papillomavirus assays for FTA card-based sampling: a pilot study in cervical cancer screening. BMC Cancer 2015; 15:848. [PMID: 26537356 PMCID: PMC4634578 DOI: 10.1186/s12885-015-1882-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 10/30/2015] [Indexed: 12/04/2022] Open
Abstract
Background Liquid-state specimen carriers are inadequate for sample transportation in large-scale screening projects in low-resource settings, which necessitates the exploration of novel non-hazardous solid-state alternatives. Studies investigating the feasibility and accuracy of a solid-state human papillomavirus (HPV) sampling medium in combination with different down-stream HPV DNA assays for cervical cancer screening are needed. Methods We collected two cervical specimens from 396 women, aged 25–65 years, who were enrolled in a cervical cancer screening trial. One sample was stored using DCM preservative solution and the other was applied to a Whatman Indicating FTA Elute® card (FTA card). All specimens were processed using three HPV testing methods, including Hybrid capture 2 (HC2), careHPV™, and Cobas®4800 tests. All the women underwent a rigorous colposcopic evaluation that included using a microbiopsy protocol. Results Compared to the liquid-based carrier, the FTA card demonstrated comparable sensitivity for detecting high grade Cervical Intraepithelial Neoplasia (CIN) using HC2 (91.7 %), careHPV™ (83.3 %), and Cobas®4800 (91.7 %) tests. Moreover, the FTA card showed a higher specificity compared to a liquid-based carrier for HC2 (79.5 % vs. 71.6 %, P = 0.015), comparable specificity for careHPV™ (78.1 % vs. 73.0 %, P > 0.05), but lower specificity for the Cobas®4800 test (62.4 % vs. 69.9 %, P = 0.032). Generally, the FTA card-based sampling medium’s accuracy was comparable with that of liquid-based medium for the three HPV testing assays. Conclusions FTA cards are a promising sample carrier for cervical cancer screening. With further optimization, it can be utilized for HPV testing in areas of varying economic development.
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Affiliation(s)
- Shao-Ming Wang
- Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, P.O. Box 2258, 17 South Panjiayuan Lane, Beijing, 100021, China.
| | - Shang-Ying Hu
- Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, P.O. Box 2258, 17 South Panjiayuan Lane, Beijing, 100021, China.
| | - Wen Chen
- Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, P.O. Box 2258, 17 South Panjiayuan Lane, Beijing, 100021, China.
| | - Feng Chen
- Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, P.O. Box 2258, 17 South Panjiayuan Lane, Beijing, 100021, China.
| | - Fang-Hui Zhao
- Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, P.O. Box 2258, 17 South Panjiayuan Lane, Beijing, 100021, China.
| | - Wei He
- Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, P.O. Box 2258, 17 South Panjiayuan Lane, Beijing, 100021, China.
| | - Xin-Ming Ma
- Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, P.O. Box 2258, 17 South Panjiayuan Lane, Beijing, 100021, China.
| | - Yu-Qing Zhang
- Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, P.O. Box 2258, 17 South Panjiayuan Lane, Beijing, 100021, China.
| | - Jian Wang
- Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, P.O. Box 2258, 17 South Panjiayuan Lane, Beijing, 100021, China. .,Beijing Municipal Institute of Labour Protection, Beijing, 100021, China.
| | - Priya Sivasubramaniam
- Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, P.O. Box 2258, 17 South Panjiayuan Lane, Beijing, 100021, China. .,Vanderbilt University School of Medicine, Nashville, TN, 37212, USA.
| | - You-Lin Qiao
- Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, P.O. Box 2258, 17 South Panjiayuan Lane, Beijing, 100021, China.
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Othman NH, Mohamad Zaki FH. Self-collection tools for routine cervical cancer screening: a review. Asian Pac J Cancer Prev 2015; 15:8563-9. [PMID: 25374168 DOI: 10.7314/apjcp.2014.15.20.8563] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Sub-optimal participation is a major problem with cervical cancer screening in developing countries which have no organized national screening program. There are various notable factors such as 'embarrassment', 'discomfort' and 'no time' cited by women as they are often also the bread winners for the family. Implementation of self-sampling methods may increase their participation. The aim of this article was to provide a survey of various types of self-sampling tools which are commonly used in collection of cervical cells. We reviewed currently available self-sampling devices and collated the advantages and disadvantages of each in terms of its acceptance and its accuracy in giving desired results. In general, regardless of which device is used, self-sampling for cervical scrapings is highly acceptable to women in most of the studies cited.
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Affiliation(s)
- Nor Hayati Othman
- Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia E-mail :
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Peluso AL, Cascone AM, Lucchese L, Cozzolino I, Ieni A, Mignogna C, Pepe S, Zeppa P. Use of FTA cards for the storage of breast carcinoma nucleic acid on fine-needle aspiration samples. Cancer Cytopathol 2015; 123:582-92. [DOI: 10.1002/cncy.21577] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 05/06/2015] [Accepted: 05/26/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Anna Lucia Peluso
- Department of Medicine and Surgery; University of Salerno; Salerno Italy
| | - Anna Maria Cascone
- Department of Medicine and Surgery; University of Salerno; Salerno Italy
| | - Lucrezia Lucchese
- Department of Medicine and Surgery; University of Salerno; Salerno Italy
| | | | - Antonio Ieni
- Section of Anatomic Pathology, “Gaetano Barresi” Department of Human Pathology; University of Messina; Messina Italy
| | - Chiara Mignogna
- Department of Pathology; Magna Grecia University of Catanzaro; Catanzaro Italy
| | - Stefano Pepe
- Department of Medicine and Surgery; University of Salerno; Salerno Italy
| | - Pio Zeppa
- Department of Medicine and Surgery; University of Salerno; Salerno Italy
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Wang SM, Hu SY, Chen F, Chen W, Zhao FH, Zhang YQ, Ma XM, Qiao YL. Clinical Evaluation of Human Papillomavirus Detection by careHPVTMTest on Physician-Samples and Self-Samples using The Indicating FTA Elute® Card. Asian Pac J Cancer Prev 2014; 15:7085-9. [DOI: 10.7314/apjcp.2014.15.17.7085] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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25
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Haguenoer K, Giraudeau B, Gaudy-Graffin C, de Pinieux I, Dubois F, Trignol-Viguier N, Viguier J, Marret H, Goudeau A. Accuracy of dry vaginal self-sampling for detecting high-risk human papillomavirus infection in cervical cancer screening: A cross-sectional study. Gynecol Oncol 2014; 134:302-8. [DOI: 10.1016/j.ygyno.2014.05.026] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 05/23/2014] [Accepted: 05/28/2014] [Indexed: 11/17/2022]
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26
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Geraets D, van Baars R, Alonso I, Ordi J, Torné A, Melchers W, Meijer C, Quint W. Clinical evaluation of high-risk HPV detection on self-samples using the indicating FTA-elute solid-carrier cartridge. J Clin Virol 2013; 57:125-9. [DOI: 10.1016/j.jcv.2013.02.016] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Revised: 02/19/2013] [Accepted: 02/22/2013] [Indexed: 02/08/2023]
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Scarinci IC, Litton AG, Garcés-Palacio IC, Partridge EE, Castle PE. Acceptability and usability of self-collected sampling for HPV testing among African-American women living in the Mississippi Delta. Womens Health Issues 2013; 23:e123-30. [PMID: 23410619 DOI: 10.1016/j.whi.2012.12.003] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Revised: 11/09/2012] [Accepted: 12/10/2012] [Indexed: 12/23/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) DNA testing has been shown to be an effective approach to cervical cancer screening, and self-collection sampling for HPV testing could be a potential alternative to Pap test, provided that women who tested positive by any method get timely follow-up and care. This feasibility study examined acceptability and usability of self-collected sampling for HPV testing among African-American (AA) women in the Mississippi Delta to inform the development of interventions to promote cervical cancer screening in this population. METHODS The study consisted of two phases. Phase I consisted of eight focus groups (n = 87) with AA women to explore knowledge, attitudes, and beliefs about cervical cancer and HPV infection as well as acceptability of self-collected sampling for HPV testing. In phase II, we examined the usability of this technology through one discussion group (n = 9). The Health Belief Model guided data collection and analysis. RESULTS Although participants perceived themselves as susceptible to cervical cancer and acknowledged its severity, there was a lack of knowledge of the link between HPV and cervical cancer, and they expressed a number of misconceptions. The most frequent barriers to screening included embarrassment, discomfort, and fear of the results. Women in both phases were receptive to self-collected sampling for HPV testing. All participants in the usability phase expressed that self-collection was easy and they did not experience any difficulties. CONCLUSION Self-collection for HPV testing is an acceptable and feasible method among AA women in the Mississippi Delta to complement current cytology cervical cancer screening programs.
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Affiliation(s)
- Isabel C Scarinci
- University of Alabama at Birmingham, Division of Preventive Medicine, Birmingham, Alabama 35294, USA.
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Guan Y, Gravitt PE, Howard R, Eby YJ, Wang S, Li B, Feng C, Qiao YL, Castle PE. Agreement for HPV genotyping detection between self-collected specimens on a FTA cartridge and clinician-collected specimens. J Virol Methods 2013; 189:167-71. [PMID: 23370404 DOI: 10.1016/j.jviromet.2012.11.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Revised: 11/05/2012] [Accepted: 11/08/2012] [Indexed: 02/03/2023]
Abstract
The current method of transporting self-collected cervicovaginal specimen for HPV DNA testing relies on liquid based medium, which is challenging and expensive to transport. A novel, dry storage and transportation device, Whatman indicating FTA™ Elute Cartridge, avoids some of the pitfalls of liquid-based medium. This method has been shown to be comparable to liquid-based collection medium, but relative performance of self-collected (SC) and clinician-collected (CC) samples onto FTA cards has not been reported. The objective of this study is to compare the analytic performance of self- and clinician-collected samples onto FTA cartridges for the detection of carcinogenic HPV using Linear Array. There was a 91% agreement, 69% positive agreement, and kappa of 0.75 between the clinician-collected and self-collected specimens for detection of any carcinogenic HPV genotype. When the HPV results were categorized hierarchically according to cervical cancer risk, there was no difference in the distribution of the HPV results for the clinician- and self-collected specimens (p=0.7). This study concludes that FTA elute cartridge is a promising method of specimen transport for cervical cancer screening programs considering using self-collected specimen and HPV testing. Larger studies with clinical endpoints are now needed to assess the clinical performance.
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Affiliation(s)
- Yaoyao Guan
- Johns Hopkins University School of Medicine, 733 N. Broadway, Baltimore, MD 21205, USA.
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29
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Gonzalez P, Cortes B, Quint W, Kreimer AR, Porras C, Rodríguez AC, Jimenez S, Herrero R, Struijk L, Hildesheim A, Melchers W. Evaluation of the FTA carrier device for human papillomavirus testing in developing countries. J Clin Microbiol 2012; 50:3870-6. [PMID: 22993174 PMCID: PMC3503011 DOI: 10.1128/jcm.01698-12] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Accepted: 09/10/2012] [Indexed: 11/20/2022] Open
Abstract
Liquid-based methods for the collection, transportation, and storage of cervical cells are cumbersome and expensive and involve laborious DNA extraction. An FTA cartridge is a solid carrier device, easier to handle and allowing simple DNA elution for human papillomavirus (HPV) testing. HPV-DNA results from cervical specimens collected in PreservCyt medium (Hologic, Inc.) and the indicating FTA elute cartridge were compared in an area where transportation and storage may affect the performance of the test. Cervical cells from 319 young adult women enrolled in the Costa Rica Vaccine Trial were collected by a nurse using a Cervex brush (Roberts), which was placed on the FTA cartridge and subsequently rinsed in 20 ml of PreservCyt medium. Two 0.5-ml PreservCyt aliquots were frozen for HPV-PCR testing; the FTA cartridges were kept at room temperature. HPV-DNA detection and typing was performed using SPF(10) PCR/DEIA (DNA enzyme immunoassay detection of amplimers)/LiPA(25) system. The percent agreement, agreement among positives, and kappas were estimated. Positivity was higher for FTA compared to PreservCyt specimens (54.5% versus 45.8%, P < 0.001). For oncogenic types, the overall agreement was 0.92, the agreement between positives was 0.74, and the kappa was 0.79. For individual HPV types, the overall agreement ranged from 0.97 to 1.00. We did not observe reduced cytology adequacy when specimen collection for cytology was preceded by FTA collection for HPV testing. HPV-DNA detection from FTA cartridges is broadly comparable to detection from PC medium. The higher HPV detection observed for FTA-collected specimens should be explored further. FTA cartridges could provide a simpler and more cost-effective method for cervical cell collection, storage, and transportation for HPV-DNA detection in research settings in developing countries.
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Affiliation(s)
- Paula Gonzalez
- Proyecto Epidemiológico Guanacaste, Fundación INCIENSA, Guanacaste, Costa Rica.
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Abreu ALP, Souza RP, Gimenes F, Consolaro MEL. A review of methods for detect human Papillomavirus infection. Virol J 2012; 9:262. [PMID: 23131123 PMCID: PMC3507852 DOI: 10.1186/1743-422x-9-262] [Citation(s) in RCA: 166] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2012] [Accepted: 11/02/2012] [Indexed: 02/07/2023] Open
Abstract
Human Papillomavirus (HPV) is the most common sexually transmitted virus. Worldwide, the most common high-risk (HR)-HPV are -16/18, and approximately 70% of cervical cancers (CC) are due to infection by these genotypes. Persistent infection by HR-HPV is a necessary but not sufficient cause of this cancer, which develops over a long period through precursor lesions, which can be detected by cytological screening. Although this screening has decreased the incidence of CC, HPV-related cervical disease, including premalignant and malignant lesions, continues to be a major burden on health-care systems. Although not completely elucidated, the HPV-driven molecular mechanisms underlying the development of cervical lesions have provided a number of potential biomarkers for both diagnostic and prognostic use in the clinical management of women with HPV-related cervical disease, and these biomarkers can also be used to increase the positive predictive value of current screening methods. In addition, they can provide insights into the biology of HPV-induced cancer and thus lead to the development of nonsurgical therapies. Considering the importance of detecting HPV and related biomarkers, a variety of methods are being developed for these purposes. This review summarizes current knowledge of detection methods for HPV, and related biomarkers that can be used to discriminate lesions with a high risk of progression to CC.
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Affiliation(s)
- André L P Abreu
- Division of Clinical Cytology, Department of Clinical Analysis and Biomedicine, State University of Maringá, Av, Colombo 5790, 87020-900, Paraná, Brazil
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Dry storage and transport of a cervicovaginal self-sample by use of the Evalyn Brush, providing reliable human papillomavirus detection combined with comfort for women. J Clin Microbiol 2012; 50:3937-43. [PMID: 23015677 DOI: 10.1128/jcm.01506-12] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Primary screening using high-risk human papillomavirus (hrHPV) detection has been suggested as a way of improving cervical cancer prevention. Women currently not attending screening (nonresponders) are more likely to participate when given the opportunity of self-sampling for hrHPV testing. The Evalyn Brush is a new cervicovaginal self-sampling device, developed specifically to meet women's demands, which is user-friendly and easy to use. The aims of this study were to investigate agreement of hrHPV detection by two PCR methods between the Evalyn Brush and physician-obtained samples and to study women's acceptance of this self-sampling device. Each of 134 women visiting the gynecology outpatient clinic collected a self-obtained sample (self-sample) and completed a questionnaire. The brush was stored dry. After self-sampling, a trained physician obtained a conventional cervical cytology specimen in ThinPrep medium. HrHPV detection was performed using the SPF(10)-DEIA-LiPA(25) and GP5+/6+-LQ-test. The overall agreement for hrHPV detection using SPF(10)-DEIA-LiPA(25) between the self-sample and the physician-taken sample was 85.8% (kappa value, 0.715; 95% confidence interval [CI], 0.597 to 0.843; P = 1.000). The overall agreement for hrHPV detection using GP5+/6+-LQ between the self-sample and the physician-taken sample was 86.6% (kappa value, 0.725; 95% CI, 0.607 to 0.843; P = 0.815). Ninety-eight percent of the women rated their experience as good to excellent. Moreover, 95% of women preferred self-sampling to physician sampling. Self-sampling using the dry Evalyn Brush system is as good as a physician-taken sample for hrHPV detection and is highly acceptable to women. To validate this self-sampling device for clinical use, a large screening cohort should be studied.
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Stevens DS, Crudder CH, Domingo GJ. Post-extraction stabilization of HIV viral RNA for quantitative molecular tests. J Virol Methods 2012; 182:104-10. [PMID: 22433512 DOI: 10.1016/j.jviromet.2012.03.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Revised: 02/13/2012] [Accepted: 03/05/2012] [Indexed: 11/19/2022]
Abstract
Two approaches to stabilize viral nucleic acid in processed clinical specimens were evaluated. HIV-1 RNA extracted from clinical specimens was stabilized in a dry matrix in a commercial product (RNAstable, Biomatrica, San Diego, CA, USA) and in a reverse-transcription reaction mixture in liquid form as cDNA. As few as 145 HIV-1 genome copies of viral RNA are reliably stabilized by RNAstable at 45°C for 92 days and in the cDNA format at 45°C for 7 days as determined by real-time PCR. With RNAstable the R(2) at days 1, 7, and 92 were 0.888, 0.871, and 0.943 when compared to baseline viral load values. The cDNA generated from the same clinical specimens was highly stable with an R(2) value of 0.762 when comparing viral load determinations at day 7 to baseline values. In conclusion viral RNA stabilized in a dry RNAstable matrix is highly stable for long periods of time at high temperatures across a substantial dynamic range. Viral RNA signal can also be stabilized in liquid in the form of cDNA for limited periods of time. Methods that reduce reliance on the cold chain and preserve specimen integrity are critical for extending the reach of molecular testing to low-resource settings. Products based on anhydrobiosis, such as the RNAstable should be evaluated further to support viral pathogen diagnosis.
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Saieg MA, Geddie WR, Boerner SL, Liu N, Tsao M, Zhang T, Kamel-Reid S, da Cunha Santos G. The use of FTA cards for preserving unfixed cytological material for high-throughput molecular analysis. Cancer Cytopathol 2012; 120:206-14. [PMID: 22275131 DOI: 10.1002/cncy.20205] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Revised: 11/01/2011] [Accepted: 11/29/2011] [Indexed: 11/08/2022]
Abstract
BACKGROUND Novel high-throughput molecular technologies have made the collection and storage of cells and small tissue specimens a critical issue. The FTA card provides an alternative to cryopreservation for biobanking fresh unfixed cells. The current study compared the quality and integrity of the DNA obtained from 2 types of FTA cards (Classic and Elute) using 2 different extraction protocols ("Classic" and "Elute") and assessed the feasibility of performing multiplex mutational screening using fine-needle aspiration (FNA) biopsy samples. METHODS Residual material from 42 FNA biopsies was collected in the cards (21 Classic and 21 Elute cards). DNA was extracted using the Classic protocol for Classic cards and both protocols for Elute cards. Polymerase chain reaction for p53 (1.5 kilobase) and CARD11 (500 base pair) was performed to assess DNA integrity. RESULTS Successful p53 amplification was achieved in 95.2% of the samples from the Classic cards and in 80.9% of the samples from the Elute cards using the Classic protocol and 28.5% using the Elute protocol (P = .001). All samples (both cards) could be amplified for CARD11. There was no significant difference in the DNA concentration or 260/280 purity ratio when the 2 types of cards were compared. Five samples were also successfully analyzed by multiplex MassARRAY spectrometry, with a mutation in KRAS found in 1 case. CONCLUSIONS High molecular weight DNA was extracted from the cards in sufficient amounts and quality to perform high-throughput multiplex mutation assays. The results of the current study also suggest that FTA Classic cards preserve better DNA integrity for molecular applications compared with the FTA Elute cards.
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Affiliation(s)
- Mauro Ajaj Saieg
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
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Zhao FH, Lewkowitz AK, Chen F, Lin MJ, Hu SY, Zhang X, Pan QJ, Ma JF, Niyazi M, Li CQ, Li SM, Smith JS, Belinson JL, Qiao YL, Castle PE. Pooled analysis of a self-sampling HPV DNA Test as a cervical cancer primary screening method. J Natl Cancer Inst 2012; 104:178-88. [PMID: 22271765 PMCID: PMC3274511 DOI: 10.1093/jnci/djr532] [Citation(s) in RCA: 126] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background Worldwide, one-seventh of cervical cancers occur in China, which lacks a national screening program. By evaluating the diagnostic accuracy of self-collected cervicovaginal specimens tested for human papillomavirus (HPV) DNA (Self-HPV testing) in China, we sought to determine whether Self-HPV testing may serve as a primary cervical cancer screening method in low-resource settings. Methods We compiled individual patient data from five population-based cervical cancer–screening studies in China. Participants (n = 13 140) received Self-HPV testing, physician-collected cervical specimens for HPV testing (Physician-HPV testing), liquid-based cytology (LBC), and visual inspection with acetic acid (VIA). Screen-positive women underwent colposcopy and confirmatory biopsy. We analyzed the accuracies of pooled Self-HPV testing, Physician-HPV testing, VIA, and LBC to detect biopsy-confirmed cervical intraepithelial neoplasia grade 2 or more severe (CIN2+) and CIN3+. All statistical tests were two-sided. Results Of 13 004 women included in the analysis, 507 (3.9%) were diagnosed as CIN2+, 273 (2.1%) as CIN3+, and 37 (0.3%) with cervical cancer. Self-HPV testing had 86.2% sensitivity and 80.7% specificity for detecting CIN2+ and 86.1% sensitivity and 79.5% specificity for detecting CIN3+. VIA had statistically significantly lower sensitivity for detecting CIN2+ (50.3%) and CIN3+ (55.7%) and higher specificity for detecting CIN2+ (87.4%) and CIN3+ (86.9%) (all P values < .001) than Self-HPV testing, LBC had lower sensitivity for detecting CIN2+ (80.7%, P = .015), similar sensitivity for detecting CIN3+ (89.0%, P = .341), and higher specificity for detecting CIN2+ (94.0%, P < .001) and CIN3+ (92.8%, P < .001) than Self-HPV testing. Physician-HPV testing was more sensitive for detecting CIN2+ (97.0%) and CIN3+ (97.8%) but similarly specific for detecting CIN2+ (82.7%) and CIN3+ (81.3%) (all P values <.001) than Self-HPV testing. Conclusions The sensitivity of Self-HPV testing compared favorably with that of LBC and was superior to the sensitivity of VIA. Self-HPV testing may complement current screening programs by increasing population coverage in settings that do not have easy access to comprehensive cytology-based screening.
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Affiliation(s)
- Fang-Hui Zhao
- Department of Epidemiology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
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Santos CR, Franciscatto LG, Barcellos RB, Almeida SEM, Rossetti MLR. Use of FTA elute card impregnated with cervicovaginal sample directly into the amplification reaction increases the detection of human papillomavirus DNA. Braz J Microbiol 2012; 43:389-92. [PMID: 24031844 PMCID: PMC3768978 DOI: 10.1590/s1517-838220120001000047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Accepted: 08/15/2012] [Indexed: 11/22/2022] Open
Abstract
This study aimed to evaluate the use of the FTA elute card(TM) impregnated with cervicovaginal sample directly in the PCR amplification for detection of HPV-DNA. The results were compared to a reference technique. This method was more efficient than the protocol indicated by the manufacturer, identifying 91.7% against 54.2% of the positive samples.
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Affiliation(s)
- Carla R Santos
- Centro de Desenvolvimento Científico e Tecnológico, Fundação Estadual de Produção e Pesquisa em Saúde , Porto Alegre, RS , Brasil ; Universidade Luterana do Brasil , Canoas, RS , Brasil
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Gustavsson I, Sanner K, Lindell M, Strand A, Olovsson M, Wikström I, Wilander E, Gyllensten U. Type-specific detection of high-risk human papillomavirus (HPV) in self-sampled cervicovaginal cells applied to FTA elute cartridge. J Clin Virol 2011; 51:255-8. [DOI: 10.1016/j.jcv.2011.05.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Revised: 04/18/2011] [Accepted: 05/03/2011] [Indexed: 11/29/2022]
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Gravitt PE, Belinson JL, Salmeron J, Shah KV. Looking ahead: a case for human papillomavirus testing of self-sampled vaginal specimens as a cervical cancer screening strategy. Int J Cancer 2011; 129:517-27. [PMID: 21384341 DOI: 10.1002/ijc.25974] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Even in the era of highly effective human papillomavirus (HPV) prophylactic vaccines, substantial reduction in worldwide cervical cancer mortality will only be realized if effective early detection and treatment of the millions of women already infected and the millions who may not receive vaccination in the next decade can be broadly implemented through sustainable cervical cancer screening programs. Effective programs must meet three targets: (i) at least 70% of the targeted population should be screened at least once in a lifetime, (ii) screening assays and diagnostic tests must be reproducible and sufficiently sensitive and specific for the detection of high-grade precursor lesions (i.e., CIN21), and (iii) effective treatment must be provided. We review the evidence that HPV DNA screening from swabs collected by the women in their home or village is sufficiently sound for consideration as a primary screening strategy in the developing world, with sensitivity and specificity for detection of CIN21 as good or better than Pap smear cytology and VIA. A key feature of a self-collected HPV testing strategy (SC-HPV) is the move of the primary screening activities from the clinic to the community. Efforts to increase the affordability and availability of HPV DNA tests, community education and awareness, development of strong partnerships between community advocacy groups, health care centers and regional or local laboratories, and resource appropriate strategies to identify and treat screen-positive women should now be prioritized to ensure successful public health translation of the technologic advancements in cervical cancer prevention.
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Affiliation(s)
- Patti E Gravitt
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
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The indicating FTA elute cartridge a solid sample carrier to detect high-risk HPV and high-grade cervical lesions. J Mol Diagn 2011; 13:371-6. [PMID: 21704269 DOI: 10.1016/j.jmoldx.2011.02.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Revised: 02/09/2011] [Accepted: 02/14/2011] [Indexed: 11/20/2022] Open
Abstract
The clinically validated high-risk human papillomavirus (hrHPV) Hybrid Capture 2 (HC2) and GP5+/6+-PCR assays were analyzed on an Indicating FTA Elute cartridge (FTA cartridge). The FTA cartridge is a solid dry carrier that allows safe transport of cervical samples. FTA cartridge samples were compared with liquid-based samples for hrHPV and high-grade cervical intraepithelial neoplasia (CIN) detection. One cervical sample was collected in a liquid-based medium, and one was applied to the FTA cartridge. DNA was eluted directly from the FTA cartridge by a simple elution step. HC2 and GP5+/6+-PCR assays were performed on both the liquid-based and the FTA-eluted DNA of 88 women. Overall agreement between FTA and liquid-based samples for the presence of hrHPV was 90.9% with GP5+/6+-PCR and 77.3% with HC2. The sensitivity for high-grade CIN of hrHPV testing on the FTA cartridges was 84.6% with GP5+/6+-PCR and only 53.8% with HC2. By comparison, these sensitivities on liquid-based samples were 92.3% and 100% for GP5+/6+-PCR and HC2, respectively. Therefore, the FTA cartridge shows reasonably good overall agreement for hrHPV detection with liquid-based media when using GP5+/6+-PCR but not HC2 testing. Even with GP5+/6+-PCR, the FTA cartridge is not yet capable of detecting all high-grade CIN lesions.
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Schmeink CE, Bekkers RLM, Massuger LFAG, Melchers WJG. The potential role of self-sampling for high-risk human papillomavirus detection in cervical cancer screening. Rev Med Virol 2011; 21:139-53. [DOI: 10.1002/rmv.686] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Channa E. Schmeink
- Department of Obstetrics and Gynaecology; Radboud University Nijmegen Medical Centre; Nijmegen; The Netherlands
| | - Ruud L. M. Bekkers
- Department of Obstetrics and Gynaecology; Radboud University Nijmegen Medical Centre; Nijmegen; The Netherlands
| | - Leon F. A. G. Massuger
- Department of Obstetrics and Gynaecology; Radboud University Nijmegen Medical Centre; Nijmegen; The Netherlands
| | - Willem J. G. Melchers
- Department of Medical Microbiology; Radboud University Nijmegen Medical Centre; Nijmegen; The Netherlands
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