Dyer Clare E F, Jin Fengyi, Roberts Jennifer M, Poynten I Mary, Farnsworth Annabelle, McNally Leon P, Cunningham Philip H, Grulich Andrew E, Hillman Richard J
Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
Douglass Hanly Moir Pathology, Sydney, NSW, Australia.
PLoS One. 2025 Jan 9;20(1):e0312781. doi: 10.1371/journal.pone.0312781. eCollection 2025.
Risk of anal cancer is high in certain populations and screening involves collection of anal swabs for HPV DNA and/or cytology testing. However, barriers exist, such as the need for an intimate examination, and stigma around HIV status, sexual orientation, and sexual practices. Self-collected anal swabs (SCA) are a proposed alternative to clinician-collected swabs (CCA) to overcome these barriers.
Participants were order-randomised to undergo SCA or CCA first, with a second swab taken immediately afterwards. Sample adequacy was assessed for HPV DNA and cytology testing. CCA was used as the gold standard to calculate sensitivity and specificity of SCA for cytology and HPV results. Acceptability of swab collection was assessed following the procedure.
There was no significant difference in sample validity for HPV DNA testing between SCA and CCA (p = 0.564). Concordance was >90% for detection of any HR-HPV and HPV16. There was no significant difference in cellular adequacy for cytological testing between SCA and CCA, (p = 0.162). Concordance for cytologic prediction was 88.2% for any cytologic abnormality. Almost half (48.5%) of participants expressed no preference for SCA versus CCA; 15.2% preferred SCA and 35.4% CCA.
SCA may be an acceptable and feasible alternative to CCA for detecting HPV and cytological abnormalities in a clinic population.
某些人群患肛门癌的风险较高，筛查需要采集肛门拭子进行人乳头瘤病毒（HPV）DNA检测和/或细胞学检测。然而，存在一些障碍，比如需要进行私密检查，以及围绕艾滋病毒感染状况、性取向和性行为的污名化问题。自我采集肛门拭子（SCA）是一种提议的替代临床医生采集拭子（CCA）的方法，以克服这些障碍。
参与者被顺序随机分组，先进行自我采集肛门拭子或临床医生采集拭子，随后立即采集第二次拭子。评估用于HPV DNA检测和细胞学检测的样本充足性。以临床医生采集拭子作为金标准，计算自我采集肛门拭子在细胞学和HPV检测结果方面的敏感性和特异性。在操作完成后评估拭子采集的可接受性。
自我采集肛门拭子和临床医生采集拭子在HPV DNA检测的样本有效性方面无显著差异（p = 0.564）。在检测任何高危型HPV和HPV16方面，一致性>90%。自我采集肛门拭子和临床医生采集拭子在细胞学检测的细胞充足性方面无显著差异（p = 0.162）。对于任何细胞学异常，细胞学预测的一致性为88.2%。几乎一半（48.5%）的参与者表示对自我采集肛门拭子和临床医生采集拭子没有偏好；15.2%的人更喜欢自我采集肛门拭子，35.4%的人更喜欢临床医生采集拭子。
对于在临床人群中检测HPV和细胞学异常，自我采集肛门拭子可能是临床医生采集拭子的一种可接受且可行的替代方法。
