Evaluation of Pre-Analytical Variables for Human Papillomavirus Primary Screening from Self-Collected Vaginal Swabs

J Mol Diagn. 2024 Jun;26(6):487-497. doi: 10.1016/j.jmoldx.2024.02.006. Epub 2024 Mar 15.

Abstract

Human papillomavirus (HPV) primary screening is an effective approach to assessing cervical cancer risk. Self-collected vaginal swabs can expand testing access, but the data defining analytical performance criteria necessary for adoption of self-collected specimens are limited, especially for those occurring outside the clinic, where the swab remains dry during transport. Here, we evaluated the performance of self-collected vaginal swabs for HPV detection using the Cobas 6800. There was insignificant variability between swabs self-collected by the same individual (n = 15 participants collecting 5 swabs per participant), measured by amplification of HPV and human β-globin control DNA. Comparison of self-collected vaginal swab and provider-collected cervical samples (n = 144 pairs) proved highly concordant for HPV detection (total agreement = 90.3%; positive percentage agreement = 84.2%). There was no relationship between the number of dry storage days and amplification of HPV (n = 68; range, 4 to 41 days). Exposure of self-collected dry swabs to extreme summer and winter temperatures did not affect testing outcomes. A second internal control (RNase P) demonstrated that lack of amplification for β-globin from self-collected specimens was consistent with poor, but not absent, cellularity. These data suggest that self-collected vaginal samples enable accurate clinical HPV testing, and that extended ambient dry storage or exposure to extreme temperatures does not influence HPV detection. Furthermore, lack of β-globin amplification in HPV-negative samples accurately identified participants who required recollection.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • DNA, Viral / analysis
  • Early Detection of Cancer / methods
  • Female
  • Human Papillomavirus Viruses* / isolation & purification
  • Humans
  • Mass Screening / methods
  • Middle Aged
  • Papillomavirus Infections* / diagnosis
  • Papillomavirus Infections* / virology
  • Specimen Handling* / methods
  • Uterine Cervical Neoplasms / diagnosis
  • Uterine Cervical Neoplasms / virology
  • Vagina / virology
  • Vaginal Smears / methods

Substances

  • DNA, Viral