Self-collected versus clinician-collected samples for HPV testing: A meta-analysis revealing lower sensitivity for detecting high-grade cervical lesions

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics Pub Date : 2026-01-01 Epub Date: 2026-03-20 DOI:10.1016/j.clinsp.2026.100898

Gabriel Gonçalves Santiago Lima, Annielson de Souza Costa, Mayara Souza Alves, Jose Antonio Orellana Turri, Lea Tami Suzuki Zuchelo, Noely Paula Cristina Lorenzi, Eduardo Carvalho de Arruda Veiga, Isabel C.E. Sorpreso, Edmund C. Baracat, José Maria Soares Junior

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引用次数: 0

Abstract

Objective

To compare the specificity and sensitivity between self-collection and collection performed by healthcare professionals in testing High-risk oncogenic Human Papillomavirus (HrHPV) to detect high-grade uterine cervical lesions.

Methods

A systematic review was conducted following PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Meta-analysis was conducted on STATA-14SE using random effects models for the aggregated values of sensitivity and specificity of studies that evaluated self-collection and collection by healthcare professionals. This review is registered on PROSPERO under CRD42022347731.

Results

This study included 17 articles. Regarding the sensitivity of the collection method, self-collection was superior to professional collection in 2 studies, inferior in 8, equivalent in 1, and variable depending on the sample storage medium, HPV DNA analysis method, or CIN grade assessed in 3. The specificity between the methods was higher with self-collection in 5 studies, lower in 5 others, equivalent in 1, not evaluated in 1, and variable depending on the HPV DNA detection method in 2 articles. The results of the meta-analysis of studies that evaluated the sensitivity and specificity of devices used for HPV detection between self-collection and health-professionals collection showed significant differences of sensitivity favorable to the health-professionals (SMD = -0.540; 95% CI -0.595 ‒ -0.486; p < 0.001). The evaluation of the sensitivity and specificity of the type of lesion between self-collection and health professionals’ collection showed significant differences in sensitivity, favorable to the health professionals (SMD = -0.872; 95% CI -1.392 ‒ -0.351; p = 0.001).

Conclusion

In conclusion, while specificity is comparable, this meta-analysis demonstrates that self-collected samples have significantly lower sensitivity for detecting HR-HPV and high-grade cervical lesions compared to clinician-collected samples. This suggests that self-sampling, in its current form, may be best utilized with complementary triage strategies or in settings where its logistical advantages outweigh the modest reduction in sensitivity for increasing screening coverage.

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自我收集与临床收集的HPV检测样本：一项荟萃分析显示，检测高级别宫颈病变的敏感性较低。

目的：比较自我采集与医务人员采集检测高危致瘤人乳头瘤病毒（HrHPV）检测宫颈高级别病变的特异性和敏感性。方法：按照PRISMA指南（系统评价和荟萃分析的首选报告项目）进行系统评价。使用随机效应模型对STATA-14SE进行meta分析，以评估医疗保健专业人员自我收集和收集的研究的敏感性和特异性的汇总值。本综述在PROSPERO注册，编号为CRD42022347731。结果：本研究纳入17篇文章。关于收集方法的敏感性，2项研究中自我收集优于专业收集，8项研究中低于专业收集，1项研究中与专业收集相当，3项研究中根据样本储存介质、HPV DNA分析方法或评估的CIN等级而有所不同。5项研究中，自收集方法的特异性较高，另外5项研究的特异性较低，1项研究的特异性相当，1项研究的特异性未被评估，2项研究的特异性取决于HPV DNA检测方法。评估自我采集和卫生专业人员采集用于HPV检测的设备的敏感性和特异性的研究的荟萃分析结果显示，对卫生专业人员有利的敏感性存在显著差异（SMD = -0.540; 95% CI -0.595 - -0.486; p < 0.001）。自我采集与卫生专业人员采集对病变类型的敏感性和特异性评价差异有统计学意义，对卫生专业人员有利（SMD = -0.872; 95% CI = -1.392 ~ -0.351; p = 0.001）。结论：虽然特异性具有可比性，但本荟萃分析表明，与临床采集的样本相比，自行采集的样本在检测HR-HPV和高级别宫颈病变方面的敏感性明显较低。这表明，目前形式的自我抽样可能最好与补充分诊策略一起使用，或者在其后勤优势超过增加筛查覆盖率的敏感性适度降低的情况下使用。

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

Clinics 医学-医学：内科

CiteScore

4.10

自引率

3.70%

发文量

129

审稿时长

52 days

期刊介绍： CLINICS is an electronic journal that publishes peer-reviewed articles in continuous flow, of interest to clinicians and researchers in the medical sciences. CLINICS complies with the policies of funding agencies which request or require deposition of the published articles that they fund into publicly available databases. CLINICS supports the position of the International Committee of Medical Journal Editors (ICMJE) on trial registration.