Comparison of Self-Collected Versus Clinician-Collected Human Papillomavirus (HPV) Sampling for Cervical Cancer Screening: A Pilot Study in the United Arab Emirates.

BACKGROUND

Cervical cancer is one of the leading causes of cancer deaths in women in the United Arab Emirates (UAE), with most deaths attributed to late detection. Most of the cervical cancer cases are linked to infection with sexually transmitted 'high-risk' types of human papillomavirus (HPV). Numerous studies have established the superiority of HPV detection in cervical samples compared to cervical cytology for the primary screening of cervical cancer. Self-collection of samples is found to be very acceptable and favored by the majority of women globally, making it a prospective way to increase women's participation in routine cervical cancer screening.

AIMS

This study was done to compare the results of self-collected HPV samples versus clinician-collected samples by using the same device (Qvintip, Aprovix, Stockholm, Sweden). Also, to find out the patient-reported acceptability and preference for the sampling technique, a feedback form was used.

METHODS AND MATERIALS

One hundred eligible women were selected at random (convenience sampling) during their visit to the Gynecology Department of Latifa Hospital, Dubai, over six months. Self-collected samples were collected by the women in the hospital, followed by clinician sampling using the Qvintip sampling device, and analyzed using the Aptima HPV assay, Panther System (Hologic, Inc, Massachusetts, USA). All participants were given a short questionnaire after the sampling procedure regarding the acceptability and preference of the sampling technique.Descriptive statistics like mean, median, and standard deviation were used to report the participant characteristics. Cross-tabulation analysis was done to calculate the p-value and kappa value (measure of agreement) between the two sampling methods. Inferential statistical analyses were conducted to explore associations between participant demographics and test results, as well as preferences for sample collection methods.

RESULTS

The findings of this study indicate a high level of agreement between self-collected and clinician-collected samples, as demonstrated by a statistically significant kappa value of 0.889 and a p-value of < 0.001. The prevalence of high-risk HPV was 9% in self-collected samples and 11% in clinician-collected samples, demonstrating consistency in detection rates between the two methods. The feedback from participants underscores the acceptability of self-sampling, with 95% finding it easy to perform, 91% reporting comfort, and 84% reporting no pain during the procedure. Also, 50% of participants expressed a preference for self-sampling over clinician collection. The chi-square test revealed no statistically significant association (χ²(2) = 0.012, = 0.994), suggesting that preference is similar regardless of nationality. Inferential statistical analyses revealed no significant differences between participant demographics (age, BMI, and parity) and HPV detection rate.

CONCLUSION

This study highlights the feasibility, acceptability, and effectiveness of HPV self-sampling as a primary screening for cervical cancer within a multicultural population in the UAE. Our findings indicate a high level of agreement between self-collected and clinician-collected HPV samples. More than 90% of women were happy with the self-sampling technique, indicating its feasibility as a culturally acceptable and reliable alternative for cervical cancer screening in the UAE.