Self- versus Clinician-Collected Swabs in Anal Cancer Screening: A Clinical Trial
Background
Anal cancer risk is high in certain groups, and screening requires anal swabs for HPV DNA and cytology tests. However, many people face challenges like the need for intimate exams and stigma related to HIV status, sexual orientation, and practices. Self-collected anal swabs (SCA) offer a potential solution to these issues.
Methods
Participants were randomly assigned to first receive either SCA or clinician-collected swabs (CCA), followed by a second swab. We checked the samples for HPV DNA and cytology testing. CCA served as the standard to evaluate how well SCA performed in detecting HPV and cytological results. We also assessed how acceptable participants found the swab collection process.
Results
There was no significant difference in the quality of samples for HPV DNA testing between SCA and CCA (p = 0.564). Both methods showed over 90% agreement in detecting high-risk HPV types. For cytology testing, there was also no significant difference in sample quality (p = 0.162), with an 88.2% agreement in identifying any cytological abnormalities. Nearly half (48.5%) of participants had no preference between SCA and CCA; 15.2% preferred SCA, while 35.4% preferred CCA.
Conclusions
SCA is a viable and acceptable alternative to CCA for detecting HPV and cytological abnormalities in clinical settings.
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