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Obstet Gynecol. 2003 Aug;102(2):266-72.

Cross-sectional study of patient- and physician-collected cervical cytology and human papillomavirus.

Author information

1
Department of Obstetrics & Gynecology, Arizona Cancer Center, Tucson, Arizona, USA. fcisco@u.arizona.edu

Abstract

OBJECTIVE:

To compare the performance of patient- and physician-obtained cytology and human papillomavirus (HPV) testing for the detection of high-grade cervical intraepithelial neoplasia.

METHODS:

A cross-sectional study was performed involving 334 women seen at three colposcopy clinics (Tucson, Arizona; Hermosillo, Mexico; and Lima, Peru). All women used a cytobrush to self-collect specimens for cervical cytology and HPV testing. Subjects subsequently underwent physician collection for cytology and HPV, followed by a complete colposcopic evaluation with directed biopsy. Cytology was processed using thin-layer technology, and HPV was determined using the polymerase chain reaction technique. Test performance characteristics were determined using the histopathologic diagnosis as the reference standard and designating high-grade cervical intraepithelial neoplasia as clinically significant disease for the purpose of the analysis.

RESULTS:

The sensitivity of patient-collected cytology was significantly lower (55.0%) and specificity was significantly better (84.1%) than those of physician-directed sampling (85.2% and 73.4%, respectively). Patient-collected HPV had significantly lower sensitivity (49.0%) than physician sampling (82.2%), although specificity did not significantly differ.

CONCLUSION:

Patient collection is a feasible although inferior alternative to physician-collected cervical cytology and HPV testing.

PMID:
12907098
DOI:
10.1016/s0029-7844(03)00517-9
[Indexed for MEDLINE]

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