Comparison of adolescent and young adult self-collected and clinician-collected samples for human papillomavirus

OBJECTIVE: To examine the concordance between self-collected and clinician-collected samples for human papillomavirus (HPV) DNA. METHODS: Sexually active adolescent and young adult women aged 14-21 years (N = 101) were enrolled in a prospective cohort study of HPV testing. Participants self-collected vaginal samples for HPV DNA, and clinicians collected cervicovaginal samples for HPV DNA and a cervical cytology specimen. We determined concordance between the results of self- and clnician-collected specimens using a K statistic and McNemar's test. RESULTS: Of the 51% of participants who were HPV positive, 53% had 1 type, 25% had 2 types, and 22% had 3 types or more; 25 different HPV types were identified. Self collected samples detected more participants with HPV than clinician-collected samples (45% versus 42%, P = .65). When results were categorized into presence or absence of high-risk HPV types, agreement between self- and clinician-collected specimens was high (kappa 0.72) and die difference between test results was not significant (McNemar's P = .41). However, when all HPV types detected were considered, agreement was perfect in only 51% of those with 1 or more types of high-risk HPV type. There was no association between agreement and age or HPV type. CONCLUSION: Self testing for HPV DNA may be sufficiently sensitive for the detection of high-risk HPV DNA among adolescent and young adult women in clinical settings. ((C) 2004 by The American College of Obstetricians and Gynecologists.).