Accuracy of HPV testing on self-collected and clinician-collected samples for different screening strategies in African settings: a systematic review and meta-analysis
Objectives - Cervical cancer still poses a considerable threat to women in low- and middle-income countries, particularly on the African continent. Self-collection of a vaginal sample promises advantages over the established sampling by clinicians. We aimed to assess the accuracy of self-sampling co...
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| Main Authors: | , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
[August 2022]
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| In: |
Gynecologic oncology
Year: 2022, Volume: 166, Issue: 2, Pages: 358-368 |
| ISSN: | 1095-6859 |
| DOI: | 10.1016/j.ygyno.2022.06.012 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.ygyno.2022.06.012 Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0090825822004164 
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| Author Notes: | Frithjof Sy, Merlin Greuel, Volker Winkler, Hermann Bussmann, Till Bärnighausen, Andreas Deckert |
MARC
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| 245 | 1 | 0 | |a Accuracy of HPV testing on self-collected and clinician-collected samples for different screening strategies in African settings |b a systematic review and meta-analysis |c Frithjof Sy, Merlin Greuel, Volker Winkler, Hermann Bussmann, Till Bärnighausen, Andreas Deckert |
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| 520 | |a Objectives - Cervical cancer still poses a considerable threat to women in low- and middle-income countries, particularly on the African continent. Self-collection of a vaginal sample promises advantages over the established sampling by clinicians. We aimed to assess the accuracy of self-sampling compared to clinician sampling in order to inform its application in primary care in the African context. - Methods - We searched Pubmed, Livivo, Web of Science, Cochrane Library and African Index Medicus on the 07th of February 2022. The eligibility criteria were: reporting (i) self-sampling against clinician-sampling, (ii) study location in Africa, (iii) relevant outcome-measures: (a) Cohen's kappa (b) sensitivity and specificity of self-sampling tests. We combined Cohen's kappa effects, additionally sensitivity and specificity estimates using random-effects models. The study is registered with PROSPERO (CRD42020218081). - Results - We included 28 studies in the systematic review and 21 studies in the meta-analysis. Self-sampling was used to test for high-risk HPV infections. Two studies additionally tested for low-risk HPV infections. The pooled Cohen's kappa was 0.66 (95%CI: 0.61-0.71). Populations at risk yielded 0.63 (95%CI: 0.56-0.71). Target amplification tests based on PCR performed best with a kappa of 0.68 (95%CI: 0.63-0.73) compared to isothermal mRNA tests, 0.61 (95%CI: 0.51-0.71). Point of care tests performed exceptionally well, 0.73 (95%CI: 0.67-0.80). Sensitivities are close to 80% and specificities close to 90% of self-sampling to detect high-risk HPV. - Conclusions - Self-sampling agrees moderately to substantially with clinician sampling in the African context. Point of care tests might be particularly suited for application in cervical cancer primary screening in low- and middle-income countries. Populations at risk should get special attention while using self-sampling. Screening protocols should be established. | ||
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| 650 | 4 | |a Cervical cancer | |
| 650 | 4 | |a Human papillomavirus | |
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