{"doi":"10.17615/ftkr-2643","title":"Pooled Analysis of a Self-Sampling HPV DNA Test as a Cervical Cancer Primary Screening Method","abstract":"BackgroundWorldwide, one-seventh of cervical cancers occur in China, which lacks a national screening program. By evaluating the diagnostic accuracy of self-collected cervicovaginal specimens tested for human papillomavirus (HPV) DNA (Self-HPV testing) in China, we sought to determine whether Self-HPV testing may serve as a primary cervical cancer screening method in low-resource settings.MethodsWe compiled individual patient data from five population-based cervical cancer–screening studies in China. Participants (n = 13 140) received Self-HPV testing, physician-collected cervical specimens for HPV testing (Physician-HPV testing), liquid-based cytology (LBC), and visual inspection with acetic acid (VIA). Screen-positive women underwent colposcopy and confirmatory biopsy. We analyzed the accuracies of pooled Self-HPV testing, Physician-HPV testing, VIA, and LBC to detect biopsy-confirmed cervical intraepithelial neoplasia grade 2 or more severe (CIN2+) and CIN3+. All statistical tests were two-sided.ResultsOf 13 004 women included in the analysis, 507 (3.9%) were diagnosed as CIN2+, 273 (2.1%) as CIN3+, and 37 (0.3%) with cervical cancer. Self-HPV testing had 86.2% sensitivity and 80.7% specificity for detecting CIN2+ and 86.1% sensitivity and 79.5% specificity for detecting CIN3+. VIA had statistically significantly lower sensitivity for detecting CIN2+ (50.3%) and CIN3+ (55.7%) and higher specificity for detecting CIN2+ (87.4%) and CIN3+ (86.9%) (all P values < .001) than Self-HPV testing, LBC had lower sensitivity for detecting CIN2+ (80.7%, P = .015), similar sensitivity for detecting CIN3+ (89.0%, P = .341), and higher specificity for detecting CIN2+ (94.0%, P < .001) and CIN3+ (92.8%, P < .001) than Self-HPV testing. Physician-HPV testing was more sensitive for detecting CIN2+ (97.0%) and CIN3+ (97.8%) but similarly specific for detecting CIN2+ (82.7%) and CIN3+ (81.3%) (all P values <.001) than Self-HPV testing.ConclusionsThe sensitivity of Self-HPV testing compared favorably with that of LBC and was superior to the sensitivity of VIA. Self-HPV testing may complement current screening programs by increasing population coverage in settings that do not have easy access to comprehensive cytology-based screening.","journal":"UNC Libraries","year":2020,"id":78406,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":18,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.6826,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":408382,"name":"J. L. Belinson","orcid":null,"position":1,"is_corresponding":false},{"id":408383,"name":"Shengye Hu","orcid":null,"position":2,"is_corresponding":false},{"id":408384,"name":"M. Niyazi","orcid":null,"position":3,"is_corresponding":false},{"id":139231,"name":"F. Chen","orcid":null,"position":4,"is_corresponding":false},{"id":408385,"name":"Qianghua Pan","orcid":null,"position":5,"is_corresponding":false},{"id":408386,"name":"C.-Q. Li","orcid":null,"position":6,"is_corresponding":false},{"id":408387,"name":"P. E. Castle","orcid":null,"position":7,"is_corresponding":false},{"id":10784,"name":"X. Zhang","orcid":"0000-0001-9155-5308","position":8,"is_corresponding":false},{"id":389173,"name":"Fanghui Zhao","orcid":"0000-0001-9294-0005","position":9,"is_corresponding":false},{"id":390965,"name":"Adam K. Lewkowitz","orcid":"0000-0002-8706-1409","position":10,"is_corresponding":false},{"id":408388,"name":"Jin-Jie Ma","orcid":null,"position":11,"is_corresponding":false},{"id":408389,"name":"S.-M. Li","orcid":null,"position":12,"is_corresponding":false},{"id":407694,"name":"Maoqiang Lin","orcid":"0000-0003-0041-0539","position":13,"is_corresponding":false},{"id":162937,"name":"J. S. Smith","orcid":"0000-0001-8866-5469","position":14,"is_corresponding":false},{"id":407693,"name":"Y.-L. Qiao","orcid":"0000-0003-3676-1023","position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":null,"created_at":"2026-07-18T21:49:40.769098Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}