Self-Collected Vaginal Specimens for HPV Testing: Recommendations From the Enduring Consensus Cervical Cancer Screening and Management Guidelines Committee.

IF 2.4 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Lower Genital Tract Disease Pub Date : 2025-04-01 Epub Date: 2025-02-21 DOI:10.1097/LGT.0000000000000885

Nicolas Wentzensen, L Stewart Massad, Megan A Clarke, Francisco Garcia, Robert Smith, Jeanne Murphy, Richard Guido, Ana Reyes, Sarah Phillips, Nancy Berman, Jeffrey Quinlan, Eileen Lind, Rebecca B Perkins

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引用次数: 0

Abstract

Objective: The Enduring Consensus Cervical Cancer Screening and Management Guidelines Committee developed recommendations for the use of self-collected vaginal specimens for human papillomavirus (HPV) testing in health care settings.

Methods: A comprehensive literature search was performed, external systematic reviews were evaluated, and HPV genotype agreement between self-collected vaginal and clinician-collected cervical specimens was summarized. Recommendations considered available data, public comments, and expert consensus. Recommendations were ratified through a vote by the Consensus Stakeholder Group.

Results: Clinician-collected cervical specimens are preferred and self-collected vaginal specimens are acceptable for primary HPV screening of asymptomatic average-risk individuals. Repeat testing in 3 years is recommended following HPV-negative screens using self-collected vaginal specimens. Colposcopy with collection of cytology and biopsies is recommended following positive tests for HPV types 16 and 18. Clinician-collected cytology or dual stain for triage testing is recommended following positive tests for HPV 45, 33/58, 31, 52, 35/39/68, or 51 or for pooled HPV other types but negative for HPV 16 or 18. Repeat HPV testing in 1 year is recommended following a positive test for HPV types 56/59/66 and no other carcinogenic types. Minimal data exist on use of self-collected vaginal specimens for surveillance following abnormal screening test results, colposcopy or treatment, and therefore, clinician-collected cervical specimens are preferred.

Conclusions: Human papillomavirus testing of self-collected vaginal specimens expands cervical cancer screening options and has potential to increase access for currently underscreened individuals. Laboratory and clinical workflows will need to be modified to ensure adequate specimen processing and follow-up.

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自收集阴道标本用于HPV检测：持久共识宫颈癌筛查和管理指南委员会的建议。

目的：持久共识宫颈癌筛查和管理指南委员会制定了在卫生保健机构中使用自行收集的阴道标本进行人乳头瘤病毒（HPV）检测的建议。方法：进行全面的文献检索，进行外部系统评价，总结自采阴道和临床采集宫颈标本间HPV基因型的一致性。建议考虑了现有数据、公众意见和专家共识。建议由协商一致利益攸关方小组投票批准。结果：临床采集的宫颈标本是首选，自行采集的阴道标本可用于无症状平均风险个体的原发性HPV筛查。建议在使用自行收集的阴道标本进行hpv阴性筛查后3年内重复检测。在HPV 16型和18型检测呈阳性后，建议进行阴道镜检查并收集细胞学和活检。在HPV 45、33/58、31、52、35/39/68或51检测呈阳性，或HPV 16或18检测呈阴性后，建议采用临床收集的细胞学检查或双染色进行分类检测。如果56/59/66型HPV检测呈阳性，且没有其他致癌类型，建议在1年内重复HPV检测。很少有数据表明，在筛查结果异常、阴道镜检查或治疗后，使用自行采集的阴道标本进行监测，因此，临床采集的宫颈标本是首选。结论：对自己收集的阴道标本进行人乳头瘤病毒检测，扩大了宫颈癌筛查的选择范围，并有可能增加目前未接受筛查的个体获得筛查的机会。需要修改实验室和临床工作流程，以确保充分的标本处理和随访。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Lower Genital Tract Disease OBSTETRICS & GYNECOLOGY-

CiteScore

6.80

自引率

8.10%

发文量

158

审稿时长

6-12 weeks

期刊介绍： The Journal of Lower Genital Tract Disease is the source for the latest science about benign and malignant conditions of the cervix, vagina, vulva, and anus. The Journal publishes peer-reviewed original research original research that addresses prevalence, causes, mechanisms, diagnosis, course, treatment, and prevention of lower genital tract disease. We publish clinical guidelines, position papers, cost-effectiveness analyses, narrative reviews, and systematic reviews, including meta-analyses. We also publish papers about research and reporting methods, opinions about controversial medical issues. Of particular note, we encourage material in any of the above mentioned categories that is related to improving patient care, avoiding medical errors, and comparative effectiveness research. We encourage publication of evidence-based guidelines, diagnostic and therapeutic algorithms, and decision aids. Original research and reviews may be sub-classified according to topic: cervix and HPV, vulva and vagina, perianal and anal, basic science, and education and learning. The scope and readership of the journal extend to several disciplines: gynecology, internal medicine, family practice, dermatology, physical therapy, pathology, sociology, psychology, anthropology, sex therapy, and pharmacology. The Journal of Lower Genital Tract Disease highlights needs for future research, and enhances health care. The Journal of Lower Genital Tract Disease is the official journal of the American Society for Colposcopy and Cervical Pathology, the International Society for the Study of Vulvovaginal Disease, and the International Federation of Cervical Pathology and Colposcopy, and sponsored by the Australian Society for Colposcopy and Cervical Pathology and the Society of Canadian Colposcopists.