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Comparison of Adolescent and Young Adult Self-Collected and Clinician-Collected Samples for Human Papillomavirus

Jessica A. Kahn, MD, MPH^*, Gail B. Slap, MD, MS^*, Bin Huang, PhD^*, Susan L. Rosenthal, PhD, Abbigail M. Wanchick^*, Linda M. Kollar, MSN^*, Paula A. Hillard, MD^*, David Witte, MD, Pam Groen and David I. Bernstein, MD^¶

From the *Division of Adolescent Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio; Center for Epidemiology and Biostatistics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio; Division of Adolescent and Behavioral Health, Department of Pediatrics, University of Texas at Galveston, Galveston, Texas; Division of Pathology, Children’s Hospital Medical Center, Cincinnati, Ohio; and ¶Division of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio.

Address reprint requests to: Jessica A. Kahn, MD, MPH, Division of Adolescent Medicine, MLC 4000, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229; e-mail: jessica.kahn{at}cchmc.org.

OBJECTIVE: To examine the concordance between self-collected and clinician-collected samples for human papillomavirus (HPV) DNA.

METHODS: Sexually active adolescent and young adult women aged 14–21 years (N = 101) were enrolled in a prospective cohort study of HPV testing. Participants self-collected vaginal samples for HPV DNA, and clinicians collected cervicovaginal samples for HPV DNA and a cervical cytology specimen. We determined concordance between the results of self- and clinician-collected specimens using a statistic and McNemar’s test.

RESULTS: Of the 51% of participants who were HPV positive, 53% had 1 type, 25% had 2 types, and 22% had 3 types or more; 25 different HPV types were identified. Self-collected samples detected more participants with HPV than clinician-collected samples (45% versus 42%, P = .65). When results were categorized into presence or absence of high-risk HPV types, agreement between self- and clinician-collected specimens was high ( 0.72) and the difference between test results was not significant (McNemar’s P = .41). However, when all HPV types detected were considered, agreement was perfect in only 51% of those with 1 or more types of high-risk HPV type. There was no association between agreement and age or HPV type.

CONCLUSION: Self testing for HPV DNA may be sufficiently sensitive for the detection of high-risk HPV DNA among adolescent and young adult women in clinical settings.

LEVEL OF EVIDENCE: II-3

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