{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T15:48:47Z","timestamp":1785858527301,"version":"3.56.0"},"reference-count":49,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2021,3,5]],"date-time":"2021-03-05T00:00:00Z","timestamp":1614902400000},"content-version":"unspecified","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Region of Southern Denmark","award":["Projekt 54579"],"award-info":[{"award-number":["Projekt 54579"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To increase effectiveness of the cervical cancer screening program, self-sampling can be an option. Both self-collected vaginal samples (SCV) and urine samples may be useful alternatives to clinician-taken cervical samples (CS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cross-sectional study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Colposcopy clinic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Women (n=305) referred to colposcopy after abnormal cervical screening result or conditions like postcoital bleeding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention<\/jats:title><jats:p>All women self-collected a urine and a vaginal sample prior to colposcopy, where a CS and biopsies were taken. All samples were tested for high-risk human papillomavirus (HPV) using the Cobas HPV assay. The gold standard was histology diagnoses (CIN2+\/CIN3+) from biopsies obtained at the same examination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Primary outcome<\/jats:title><jats:p>Absolute and relative sensitivity and specificity of HPV testing on SCV and urine to detect CIN2+\/CIN3+ compared with\u2009the CS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Secondary outcome<\/jats:title><jats:p>The acceptability by women of self-sampling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Both the vaginal and urine sample were comparable to the CS in identifying severe intraepithelial neoplasia (CIN2+\/CIN3+). Absolute sensitivity ranged from 93% for urine samples to 96% for SCV for detecting CIN2+, which is comparable to the sensitivity of CS (overlapping 95%\u2009CI).<\/jats:p><jats:p>The relative sensitivity for detecting CIN2+ was 1.00 (95% CI 0.96 to 1.04) for SCV and 0.96 (95% CI 0.91 to 1.03) for urine samples. At CIN3+, the relative sensitivity was 1.00 (95% CI 0.96 to 1.08) and 0.97 (95% CI 0.89 to 1.07) for SCV and urine samples, respectively. There were no statistical differences between the self-collected samples and the CS (McNemar\u2019s test &gt;0.05). The relative specificity was also similar (1.03 (95% CI 0.95 to 1.12) for SCV and 0.98 (95% CI 0.89 to 1.09) for urine samples) (McNemar\u2019s test &gt;0.05).<\/jats:p><jats:p>The acceptability of self-sampling was evaluated by questionnaire. The women found the instructions on sample collection easy to understand and were positive about self-sampling with a preference for the urine sample.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Self-sampling by SCV and urine is a clinically safe alternative to CS with a high degree of acceptability.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2020-041512","type":"journal-article","created":{"date-parts":[[2021,3,5]],"date-time":"2021-03-05T19:54:37Z","timestamp":1614974077000},"page":"e041512","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":64,"title":["Clinical performance and acceptability of self-collected vaginal and urine samples compared with clinician-taken cervical samples for HPV testing among women referred for colposcopy. 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