Title: Pilot study in UAE -comparing self-collected vs clinician-collected HPV samples for screening.

Authors:

Shalini Fernandes 1,3, Nabila Mashharawi1,3, Ayisha Ejaz Bhutta 1,Rupa Murthy Varghese 2, Aydah Belal Jamil Ghanim Al Ali 2, Nighat Aftab Raza 1, Muna Abdul Razzaq Tahlak 1,3, Eiman Saeed Mobarak Obaid Al Zahmi1,3, Nadia Jamal Al Sawalhee1,Zulfa Omar Deesi2, 1Department of Obstetrics and Gynecology, Latifa Women and Children Hospital, Dubai Health, Dubai, UAE 2 Department of Pathology & Genetics, Latifa Women and Children Hospital, Dubai Health, Dubai, UAE 3Department of Obstetrics and Gynecology, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai,

Background:

Cervical cancer is the fifth leading female cancer overall and the third most common female cancer in women in the UAE

About 99% of all cervical cancer cases are linked to infection with sexually transmitted ‘high-risk’ types of human papillomavirus (HPV)

In recent years, HPV detection in cervical samples has been demonstrated to be more effective than cervical cytology for the primary screening of cervical cancer. Self-collection of samples is reported to be highly acceptable and preferred by most women, worldwide.

Self-collection has significant benefits over traditional sampling in terms of cost, coverage, and patient convenience.

AIM:

To compare the efficacy of self-collected samples versus clinician-collected samples in the detection of HPV by PCR, using a self-sampling device (Qvintip, Aprovix, Stockholm, Sweden).

To determine the patient-reported acceptability and preference for the sampling technique using a feedback form.

Study Design/ Methods :

Approved by Dubai Scientific Research Ethics Committee with reference no. DSREC-04/2022_03, dated 16th June 2022

100 women attending the Gynecology clinic, in Latifa Hospital

Informed written consent.

The patient collected a self-sample at the hospital.

A clinician obtained a sample using the Qvintipsampling device.

The samples were promptly sent to the laboratory for analysis with the Aptima HPV assay.

After the procedure, participants completed a brief questionnaire regarding the acceptability and preference of the sampling technique

Results: HPV positivity rates between the self collected and clinician collected specimens using Aptima HPV assay of E6/E7 mRNA for 14 high risk types, is in fair agreement.

More than 90% of women were happy with the self collection technique.

Conclusion:

This study explores the HPV self-sampling technique and its acceptability and preference among the multicultural population of the UAE. Understanding the preferences for self-sampling is essential to achieve the WHO global target of 70% HPV screening coverage by 2030. Therefore, HPV screening programs could consider offering this alternative option for home use, which may increase cervical cancer screening uptake and lessen the strain on clinical infrastructure.

References:

1. Cervical cancer” World Health Organization, Accessed April 14, 2023, https://www.who.int/health-topics/cervical-cancer 2. Human Papillomavirus and Related Diseases Report, UAE Version posted at www.hpvcentre.net on 10 March 2023 3. Aranda Flores, C.E., Gomez Gutierrez, G., Ortiz Leon, J.M. et al, Self-collected versus clinician collected cervical samples for the detection of HPV infections by 14-type DNA &7-type mRNA tests, BMC Infect Dis 21, 504 ,2021, https://doi.org/10.1186/s12879-021-06189-2 4. Giorgi Rossi P, Fortunato C, Barbarino P, Boveri S, Caroli S, Del MistroA, et al. Self-sampling to increase participation in cervical cancer screening: an RCT comparing home mailing, distribution in pharmacies, and recall letter. British Journal of Cancer. 2015 Jan 29;112(4):667–75. 5.Wong EL-Y, Cheung AW-L, Wong AY-K, Chan PK-S, Acceptability and Feasibility of HPV Self-Sampling as an Alternative Primary Cervical Cancer Screening in Under-Screened Population Groups: A Cross-Sectional Study. International Journal of Environmental Research and Public Health. 2020 Aug 27;17(17):6245, https://doi.org/10.3390/ijerph17176245