HPV, cytologic evaluation: investigational patient self-test yields few endocervical cells.(Gynecology)

SAN DIEGO -- A device designed for women to collect their own cervicovaginal samples for cytologic and human papillomavirus evaluation yielded a high number of cells but few endocervical cells, compared with a regular Pap test performed by a health care provider, in a study of 765 women.

"The self-test was clearly better than the provider-collected sample for detecting HPV, and was about the same for detecting abnormal cells, but it was far inferior for collecting endocervical cells," reported Dr. Andrew Soisson, professor of obstetrics and gynecology at the University of Utah, Salt Lake City.

The study, which he presented at the annual meeting of the Society of Gynecologic Oncologists, recruited participants from 35 health department sites in West Virginia.

Patients were asked to provide a vaginal/cervical sample using the self-test and were then asked to undergo a regular Pap and HPV test performed by a health care provider. When the results were compared, there was "sufficient cellular material for cytologic analysis" in 99% of both tests, and sufficient cells for HPV analysis in 95% of self-collected tests (SC) and 90% of provider-collected tests (PC), reported Dr. Soisson.

Only 12% of SC samples contained endocervical cells, compared with 77% of PC samples, however.

"The presence of endocervical cells makes it much more likely that you will detect dysplastic cells," Dr. Soisson said.

"Since the great majority of self-collected specimens did not contain endocervical cells, the majority of the specimens would have to be classified as inadequate. The question that remains, and ...