{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:14:30Z","timestamp":1791292470778,"version":"4.1.0"},"reference-count":48,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2020,11,10]],"date-time":"2020-11-10T00:00:00Z","timestamp":1604966400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"SAMRC-FORTE"},{"name":"National Research Foundation South Africa","award":["64815"],"award-info":[{"award-number":["64815"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Human papillomavirus (HPV) testing on vaginal self-collected and cervical clinician-collected specimens shows comparable performance. Self-sampling on FTA cards is suitable for women residing in rural settings or not attending regular screening and increases participation rate in the cervical cancer screening programme. We aimed to investigate and compare high-risk (HR)-HPV prevalence in clinician-collected and self-collected genital specimens as well as two different HPV tests on the clinician collected samples. A total of 737 women were recruited from two sites, a community health clinic (n = 413) and a referral clinic (n = 324) in the Eastern Cape Province. Cervical clinician-collected (FTA cards and Digene transport medium) and vaginal self-collected specimens were tested for HR-HPV using the <jats:italic>hpVIR<\/jats:italic> assay (FTA cards) and Hybrid Capture-2 (Digene transport medium). There was no significant difference in HR-HPV positivity between clinician-collected and self-collected specimens among women from the community-based clinic (26.4% vs 27.9%, p = 0.601) or the referral clinic (83.6% vs 79.9%, <jats:italic>p<\/jats:italic> = 0.222). HPV16, HPV35, and HPV33\/52\/58 group were the most frequently detected genotypes at both study sites. Self-sampling for HPV testing received a high positive response of acceptance (77.2% in the community-based clinic and 83.0% in referral clinic). The overall agreement between <jats:italic>hpVIR<\/jats:italic> assay and HC-2 was 87.7% (k = 0.754). The study found good agreement between clinician-collected and self-collected genital specimens. Self-collection can have a positive impact on a cervical screening program in South Africa by increasing coverage of women in rural areas, in particular those unable to visit the clinics and women attending clinics where cytology-based programs are not functioning effectively.<\/jats:p>","DOI":"10.1371\/journal.pone.0241781","type":"journal-article","created":{"date-parts":[[2020,11,10]],"date-time":"2020-11-10T19:13:11Z","timestamp":1605035591000},"page":"e0241781","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":22,"title":["Acceptability of self- collection for human papillomavirus detection in the Eastern Cape, South Africa"],"prefix":"10.1371","volume":"15","author":[{"given":"Ongeziwe","family":"Taku","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy L.","family":"Meiring","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inger","family":"Gustavsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keletso","family":"Phohlo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirta","family":"Garcia-Jardon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zizipho Z. 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Summary Report https:\/\/wwwhpvcentrenet\/statistics\/reports\/XWXpdf (Accessed 28 June 2019)."},{"key":"pone.0241781.ref002","doi-asserted-by":"crossref","first-page":"e191","DOI":"10.1016\/S2214-109X(19)30482-6","article-title":"Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis","volume":"8","author":"M Arbyn","year":"2020","journal-title":"Lancet Glob Health"},{"key":"pone.0241781.ref003","unstructured":"Bruni L, Albero G, Serrano B, Mena M, G\u00f3mez D, Mu\u00f1oz J, et al. 2019. ICO\/IARC Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Diseases in South Africa. Summary Report https:\/\/hpvcentrenet\/statistics\/reports\/ZAFpdf (Accessed 28 February 2019)."},{"key":"pone.0241781.ref004","unstructured":"Africa NnfcdoS. 2020. Summary statistics of cancer diagnosed histologically in 2016. https:\/\/wwwnicdacza\/wp-content\/uploads\/2020\/04\/NCR_2016_Report_updated_14April2020pdf (Accessed June 2020)."},{"key":"pone.0241781.ref005","first-page":"Cd009069","article-title":"Prophylactic vaccination against human papillomaviruses to prevent cervical cancer and its precursors","volume":"5","author":"M Arbyn","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"pone.0241781.ref006","unstructured":"Denny L, Herrero R, Levin C, Kim JJ. 2015. Cervical Cancer. In Gelband H, Jha P, Sankaranarayanan R, Horton S (ed), Cancer: Disease Control Priorities, Third Edition (Volume 3) 10.1596\/978-1-4648-0349-9_ch4. The International Bank for Reconstruction and Development \/ The World Bank \u00a9 2015 International Bank for Reconstruction and Development \/ The World Bank., Washington (DC)."},{"key":"pone.0241781.ref007","first-page":"111","article-title":"Evaluation of cervical cancer screening program at a rural community of South Africa","volume":"5","author":"M Hoque","year":"2008","journal-title":"East Afr J Public Health"},{"key":"pone.0241781.ref008","unstructured":"WHO. 2014. Comprehensive cervical cancer control\u2014A guide to essential practice. https:\/\/wwwwhoint\/reproductivehealth\/publications\/cancers\/cervical-cancer-guide\/en\/ (accessed March 2020)."},{"key":"pone.0241781.ref009","doi-asserted-by":"crossref","first-page":"849","DOI":"10.3934\/publichealth.2016.4.849","article-title":"Choropleth Mapping of Cervical Cancer Screening in South Africa Using Healthcare Facility-level Data from the National Laboratory Network","volume":"3","author":"CBT Makura","year":"2016","journal-title":"AIMS public health"},{"key":"pone.0241781.ref010","doi-asserted-by":"crossref","first-page":"48","DOI":"10.4102\/curationis.v30i1.1050","article-title":"An assessment of the implementation of the provincial cervical screening programme in selected Primary Health Care Clinics in the Ilembe Region, KwaZulu-Natal","volume":"30","author":"MN Sibiya","year":"2007","journal-title":"Curationis"},{"key":"pone.0241781.ref011","doi-asserted-by":"crossref","first-page":"264","DOI":"10.2471\/BLT.06.031195","article-title":"Determinants of womens participation in cervical cancer screening trial, Maharashtra, India","volume":"85","author":"B Nene","year":"2007","journal-title":"Bull World Health Organ"},{"key":"pone.0241781.ref012","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1258\/jms.2009.009073","article-title":"Barriers to cervical cancer screening attendance in England: a population-based survey","volume":"16","author":"J Waller","year":"2009","journal-title":"J Med Screen"},{"key":"pone.0241781.ref013","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1007\/s10900-010-9289-7","article-title":"Examining barriers to cervical cancer screening and treatment in Florida through a socio-ecological lens","volume":"36","author":"E Daley","year":"2011","journal-title":"J Community Health"},{"key":"pone.0241781.ref014","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1001\/jama.2018.7464","article-title":"Effect of Screening With Primary Cervical HPV Testing vs Cytology Testing on High-grade Cervical Intraepithelial Neoplasia at 48 Months: The HPV FOCAL Randomized Clinical Trial","volume":"320","author":"GS Ogilvie","year":"2018","journal-title":"Jama"},{"key":"pone.0241781.ref015","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.pvr.2019.04.001","article-title":"Optimising future cervical screening strategies","volume":"7","author":"H Kitchener","year":"2019","journal-title":"Papillomavirus Res"},{"key":"pone.0241781.ref016","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1056\/NEJMoa0808516","article-title":"HPV screening for cervical cancer in rural India","volume":"360","author":"R Sankaranarayanan","year":"2009","journal-title":"N Engl J Med"},{"key":"pone.0241781.ref017","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.ypmed.2019.04.025","article-title":"Experience with HPV self-sampling and clinician-based sampling in women attending routine cervical screening in the Netherlands","volume":"125","author":"NJ Polman","year":"2019","journal-title":"Prev Med"},{"key":"pone.0241781.ref018","unstructured":"Committee MSA. 2014. National Cervical Screening Program renewal: effectiveness modelling and economic evaluation in the Australian setting. Report November 2013. 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Colposcopy and treatment if cervical intraepithelial neoplasia:a beginners\u2019 manual. IARC; https:\/\/screeningiarcfr\/colpophp."},{"key":"pone.0241781.ref029","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1186\/s12985-019-1216-7","article-title":"Clinical validation of the HPVIR high-risk HPV test on cervical samples according to the international guidelines for human papillomavirus DNA test requirements for cervical cancer screening","volume":"16","author":"I Gustavsson","year":"2019","journal-title":"Virol J"},{"key":"pone.0241781.ref030","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.jcv.2009.04.012","article-title":"Comparison between the Hybrid Capture 2 and the hpVIR real-time PCR for detection of human papillomavirus in women with ASCUS or low grade dysplasia","volume":"45","author":"I Gustavsson","year":"2009","journal-title":"J Clin Virol"},{"key":"pone.0241781.ref031","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.jcv.2012.02.022","article-title":"Brush-based self-sampling in combination with GP5+\/6+-PCR-based hrHPV testing: high concordance with physician-taken cervical scrapes for HPV genotyping and detection of high-grade CIN","volume":"54","author":"MG Dijkstra","year":"2012","journal-title":"J Clin Virol"},{"key":"pone.0241781.ref032","unstructured":"Arbyn M, Haelens A, Desomer A, Verdoodt F, Thiry N, Francart J, et al. 2015. Cervical cancer screening program and Human Papillomavirus (HPV) testing, part II: Update on HPV primary screening. Health Technology Assessment (HTA) Brussels: Belgian Health Care Knowledge Centre (KCE) KCE Reports 238."},{"key":"pone.0241781.ref033","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1038\/bjc.2017.485","article-title":"Randomised study shows that repeated self-sampling and HPV test has more than two-fold higher detection rate of women with CIN2+ histology than Pap smear cytology","volume":"118","author":"I Gustavsson","year":"2018","journal-title":"Br J Cancer"},{"key":"pone.0241781.ref034","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/S1473-3099(07)70158-5","article-title":"Worldwide prevalence and genotype distribution of cervical human papillomavirus DNA in women with normal cytology: a meta-analysis","volume":"7","author":"S de Sanjos\u00e9","year":"2007","journal-title":"Lancet Infect Dis"},{"key":"pone.0241781.ref035","first-page":"514146","article-title":"HPV Type Distribution and Cervical Cytology among HIV-Positive Tanzanian and South African 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Awua","year":"2016","journal-title":"Infectious agents and cancer"},{"key":"pone.0241781.ref039","doi-asserted-by":"crossref","first-page":"100186","DOI":"10.1016\/j.pvr.2019.100186","article-title":"Diversity of human papillomavirus typing among women population living in rural and remote areas of Brazilian territory","volume":"8","author":"AT Lorenzi","year":"2019","journal-title":"Papillomavirus Res"},{"key":"pone.0241781.ref040","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.canep.2014.01.004","article-title":"Comparison of HPV genotypes and viral load between different sites of genital tract: the significance for cervical cancer screening","volume":"38","author":"SK Zhang","year":"2014","journal-title":"Cancer Epidemiol"},{"key":"pone.0241781.ref041","doi-asserted-by":"crossref","first-page":"e029158","DOI":"10.1136\/bmjopen-2019-029158","article-title":"HPV self-sampling acceptability in rural and indigenous communities in Guatemala: a cross-sectional 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