A randomised comparison of different vaginal self-sampling devices and urine for human papillomavirus testing - Predictors 5.1.

Background: HPV-based screening is rapidly replacing cytology as the cervical screening modality of choice. In addition to being more sensitive than cytology, it can be done on self-collected vaginal or urine samples. This study will compare the hrHPV positivity rates and sensitivity of self-collected vaginal samples using four different collection devices and a urine sample. Methods: 620 women referred for colposcopy were invited to provide an initial stream urine sample collected with the Colli-Pee® device and take two vaginal self-samples, using either a dry flocked swab (DF) and a Dacron swab (WD), or a HerSwab (HS) and Qvintip (QT) device. HPV testing was performed by the BD OnclarityTM HPV Assay. Results: 600 vaginal sample pairs were suitable for analysis and 505 were accompanied by a urine sample. Similar positivity rates and sensitivities for CIN2+ and CIN3+ were seen for DF, WD and urine, but lower values were seen for QT and HS. No clear user preferences were seen between devices, but women found urine easiest to collect, and were more confident they had taken the sample correctly. The lowest confidence in collection was reported for HS. Conclusions: Urine, a dry flocked swab and wet dacron swab all performed well and were well received by the women, whereas the Qvintip and HerSwab devices were less satisfactory. Impact: This is the first study to compare five self-sampling methods in the same women taken at the same time. It supports wider use of urine or vaginal self-sampling for cervical screening.