{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T06:22:24Z","timestamp":1778653344831,"version":"3.51.4"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2011,10,21]],"date-time":"2011-10-21T00:00:00Z","timestamp":1319155200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2012,1]]},"abstract":"<jats:p><jats:italic>Please cite this paper as:<\/jats:italic> Lindell M, Sanner K, Wikstr\u00f6m I, Wilander E. Self\u2010sampling of vaginal fluid and high\u2010risk human papillomavirus testing in women aged 50\u2003years or older not attending Papanicolaou smear screening. BJOG 2012;119:245\u2013248.<\/jats:p><jats:p><jats:bold>Objectives\u2002<\/jats:bold> To study the value of self\u2010sampling of vaginal fluid at home in combination with high\u2010risk human papillomavirus (HPV) testing in a cohort of older women not attending Papanicolaou (Pap) smear screening.<\/jats:p><jats:p><jats:bold>Design\u2002<\/jats:bold> Women (<jats:italic>n<\/jats:italic>\u2003=\u20033618), aged 50\u201365\u2003years, who had not attended screening for at least 6\u2003years were offered self\u2010sampling of vaginal fluid at home (study cohort). The collected material was analysed for the presence of high\u2010risk HPV (using Hybrid capture 2; Hc2). Women with a positive HPV test were referred for colposcopy. These results were compared with the results of Pap smear screening in a corresponding age group of women (controls). The end point of the study was identification of a histological cervical intraepithelial neoplasia stage 2 (CIN2) and above (CIN2+).<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> In all, 39.4% (<jats:italic>n<\/jats:italic>\u2003=\u20031426) women participated and 4.6% (<jats:italic>n<\/jats:italic>\u2003=\u200366) were high\u2010risk HPV positive. Of the HPV\u2010positive women 56 chose to attend a surgery (84.8%) after a mean time of 2.1\u2003months and ten of these women (17.9%) showed CIN2+, corresponding to 0.70% of all participating women. In the controls, who participated in organised Pap smear screening, the prevalence of CIN2+ was 0.25% (15\/6048). The odds ratio for identification of CIN2+ in women aged 50\u2003years or older performing self\u2010sampling and HPV test in comparison with Pap smear was: 2.84 (95% CI 1.14\u20136.77, <jats:italic>P<\/jats:italic>\u2003=\u20030.0174). In older women primary high\u2010risk HPV testing (Hc2) and Pap smear screening showed equal specificity of around 96%.<\/jats:p><jats:p><jats:bold>Conclusions\u2002<\/jats:bold> Self<jats:bold>\u2010<\/jats:bold>sampling of vaginal fluid in combination with high\u2010risk HPV testing appears to be an attractive method to improve screening coverage and decrease the prevalence of cervical cancer in women aged 50\u2003years or older.<\/jats:p>","DOI":"10.1111\/j.1471-0528.2011.03147.x","type":"journal-article","created":{"date-parts":[[2011,10,21]],"date-time":"2011-10-21T12:44:41Z","timestamp":1319201081000},"page":"245-248","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Self\u2010sampling of vaginal fluid and high\u2010risk human papillomavirus testing in women aged 50\u2003years or older not attending Papanicolaou smear screening"],"prefix":"10.1111","volume":"119","author":[{"given":"M","family":"Lindell","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Sanner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I","family":"Wikstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Wilander","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2011,10,21]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djn099"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.22114"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2006.12.005"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000109426.82624.f8"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.24010"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(09)70360-2"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c1804"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)04956-4"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djn044"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.1086\/516784"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-0123"},{"key":"e_1_2_9_13_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6605194"},{"key":"e_1_2_9_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0215(19970410)71:2<159::AID-IJC6>3.0.CO;2-#"},{"key":"e_1_2_9_15_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6690666"},{"key":"e_1_2_9_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(10)70064-4"},{"key":"e_1_2_9_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.2910630610"},{"key":"e_1_2_9_18_2","doi-asserted-by":"crossref","first-page":"1612","DOI":"10.1093\/jnci\/djp367","article-title":"Age\u2010specific evaluation of primary human papillomavirus screening vs conventional cytology in a randomized setting","volume":"101","author":"Leinonen M","year":"2009","journal-title":"J Natl Cancer Inst"},{"key":"e_1_2_9_19_2","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.346.13.3"},{"key":"e_1_2_9_20_2","first-page":"340","article-title":"HPV testing on self collected cervicovaginal lavage specimens as screening method for women who do not attend cervical screening: cohort study","volume":"11","author":"G\u00f6k M","year":"2010","journal-title":"BMJ"},{"key":"e_1_2_9_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2009.10.013"},{"key":"e_1_2_9_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.21835"},{"key":"e_1_2_9_23_2","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-0326"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; 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