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1038 A prospective study of filter paper card for the detection of human papilloma virus DNA in self-collected cervicovaginal samples
  1. R Ck1,
  2. A Thomas2,
  3. R Kannangai3,
  4. A Sebastian2,
  5. J Dickson Calvin3,
  6. V Thomas2,
  7. D Susan Thomas2,
  8. R George Chandy2,
  9. P Abraham3 and
  10. A Peedicayil2
  1. 1Christian Medical College, Vellore, Department of Gynecologic Oncology
  2. 2Christian Medical College, Vellore, Department of Gynecologic Oncology, Tamil Nadu, India
  3. 3Christian Medical College, Vellore, Department of Virology, Tamil Nadu, India


Introduction/Background*Many countries worldwide have recommended testing high-risk human papillomavirus (HPV) types for primary cervical cancer screening. New easy and patient-friendly screening methods for identifying high-risk HPV types are under evaluation and may facilitate the use of HPV testing in low-resource countries.

Aim To compare the accuracy of detecting high-risk HPV DNA on dried cervicovaginal secretions on filter paper to the standard technique.

Methods our study was a prospective diagnostic study where we recruited 40 patients with abnormal pap smear cytology. Three samples were collected from each patient, 1) self-collected cervicovaginal sample on filter paper, 2) cervical sample on filter paper collected by a physician, and 3) a cytobrush sample in specimen transport medium (STM) for analysis. Qualitative testing for high-risk HPV DNA was done using the hybrid capture technique. Sensitivity, specificity and NPV and PPV, and agreement of new method with the standard procedure were calculated.

Result(s)*Of the 40 patients, 32.5% had low-grade lesions, and 67.5% had high-grade lesions on the pap smear. The overall prevalence of High-risk HPV in the sample was 67.5%. Detection of high-risk HPV DNA in the cervical sample collected on filter paper by the physician had a sensitivity of 77.8%, specificity 100%, positive predictive value 100%, and negative predictive value of 68.4%, taking STM as the gold standard. The patient‘s self-sampling of cervicovaginal secretions on filter paper also showed similar results, with sensitivity 66.7%, specificity 100%, PPV 100%, and NPV 59.1%. The agreement between the STM method and physician collected cervical sample on filter paper was substantial, kappa: 0.695(P= <0.001) and STM method and Self-collected samples on filter paper were moderate, kappa:0.565(P=<0.001). Most of the patients reported self-collection was acceptable (100%), not painful (95%), and not embarrassing (95%). But when asked whom they should prefer to do the test majority wanted the doctor to do it (95%).

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Conclusion*Our study showed that dried cervicovaginal samples collected by the patient on filter paper to detect High-Risk HPV could be done with acceptable accuracy and cost. It can be used as an alternative STM method for screening cervical cancer where a more uncomplicated, cost-effective technique may be better.

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