{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T17:04:37Z","timestamp":1781975077731,"version":"3.54.5"},"reference-count":24,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T00:00:00Z","timestamp":1647993600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Human papillomavirus (HPV) testing using self-collected vaginal specimens is the preferred choice to increase screening uptake. Although the HPV testing results of these samples depend on the cells that naturally exfoliate from the cervical lesion and drift into the vagina, the mechanism of when and how these exfoliated cells mix with the self-collected sample remains unclear. Hence, the study aimed to clarify the relationship between the vaginal drift of HPV-infected cells exfoliated from the cervix, and the menstrual cycle. A total of 180 scraped samples of the cervix and vagina were examined. The exfoliated cells were classified into two categories according to the HPV genotyping results of each sample: sufficient accumulation (same HPV types in cervical and vaginal samples) and insufficient accumulation (fewer HPV types in vaginal samples than in cervical samples, or HPV positivity in cervical samples and HPV negativity in vaginal samples). A moderately strong statistically significant association was observed between exfoliated cell accumulation and the menstrual cycle, and insufficient accumulation was statistically significantly increased at the early proliferative phases. Self-collection of vaginal samples at the early proliferation phase indicates insufficient sample quantities or lower viral load, thereby affecting HPV genotyping.<\/jats:p>","DOI":"10.3390\/microorganisms10040693","type":"journal-article","created":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T22:08:06Z","timestamp":1648073286000},"page":"693","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Effects of Menstrual Cycle on the Accumulation of Human Papillomavirus-Infected Cells Exfoliated from the Cervix That Drift into the Vagina"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6152-3217","authenticated-orcid":false,"given":"Mitsuaki","family":"Okodo","sequence":"first","affiliation":[{"name":"Department of Medical Technology, Faculty of Health Sciences, Kyorin University, 5-4-1 Shimorenjaku, Mitaka-shi, Tokyo 181-8621, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaori","family":"Okayama","sequence":"additional","affiliation":[{"name":"Department of Health Science, Gunma Paz University Graduate School of Health Sciences, 1-7-1 Tonyamachi, Takasaki-shi, Gunma 370-0006, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2787-4184","authenticated-orcid":false,"given":"Koji","family":"Teruya","sequence":"additional","affiliation":[{"name":"Department of Health and Welfare, Faculty of Health Sciences, Kyorin University, 5-4-1 Shimorenjaku, Mitaka-shi, Tokyo 181-8621, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazumasa","family":"Tanabe","sequence":"additional","affiliation":[{"name":"Department of Medical Technology, Faculty of Health Sciences, Kyorin University, 5-4-1 Shimorenjaku, Mitaka-shi, Tokyo 181-8621, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chieko","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Genki Plaza Medical Center for Health Care, 1-7-1 Jinbocho, Chiyoda-ku, Tokyo 101-0051, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuyoshi","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Genki Plaza Medical Center for Health Care, 1-7-1 Jinbocho, Chiyoda-ku, Tokyo 101-0051, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Fujii","sequence":"additional","affiliation":[{"name":"Department of Medical Technology, Faculty of Health Sciences, Kyorin University, 5-4-1 Shimorenjaku, Mitaka-shi, Tokyo 181-8621, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirokazu","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of Health Science, Gunma Paz University Graduate School of Health Sciences, 1-7-1 Tonyamachi, Takasaki-shi, Gunma 370-0006, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mizue","family":"Oda","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Genki Plaza Medical Center for Health Care, 1-105 Jinbocho, Chiyoda-ku, Tokyo 101-0051, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"147","DOI":"10.3322\/caac.21139","article-title":"American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer","volume":"62","author":"Saslow","year":"2012","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.ygyno.2014.11.076","article-title":"Primary cervical cancer screening with human papillomavirus: End of study results from the ATHENA study using HPV as the first-line screening test","volume":"136","author":"Wright","year":"2015","journal-title":"Gynecol. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e55","DOI":"10.3802\/jgo.2020.31.e55","article-title":"National screening programs for cervical cancer in Asian countries","volume":"31","author":"Aoki","year":"2020","journal-title":"J. Gynecol. Oncol."},{"key":"ref_4","unstructured":"(2022, January 31). Center for Cancer Control and Information Services. Available online: https:\/\/ganjoho.jp\/en\/index.html."},{"key":"ref_5","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":"Waller","year":"2009","journal-title":"J. Med. Screen."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/S1470-2045(13)70570-9","article-title":"Accuracy of human papillomavirus testing on self-collected versus clinician-collected samples: A meta-analysis","volume":"15","author":"Arbyn","year":"2014","journal-title":"Lancet Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2375","DOI":"10.1016\/j.ejca.2015.07.006","article-title":"Reaching women who do not participate in the regular cervical cancer screening programme by offering self-sampling kits: A systematic review and meta-analysis of randomised trials","volume":"51","author":"Verdoodt","year":"2015","journal-title":"Eur. J. Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Sultana, F., Mullins, R., English, D.R., Simpson, J.A., Drennan, K.T., Heley, S., Wrede, C.D., Brotherton, J.M., Saville, M., and Gertig, D.M. (2015). Women\u2019s experience with home-based self-sampling for human papillomavirus testing. BMC Cancer, 15.","DOI":"10.1186\/s12885-015-1804-x"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1093\/jnci\/djr532","article-title":"Pooled analysis of a self-sampling HPV DNA test as a cervical cancer primary screening method","volume":"104","author":"Zhao","year":"2012","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/S1470-2045(18)30763-0","article-title":"Performance of human papillomavirus testing on self-collected versus clinician-collected samples for the detection of cervical intraepithelial neoplasia of grade 2 or worse: A randomised, paired screen-positive, non-inferiority trial","volume":"20","author":"Polman","year":"2019","journal-title":"Lancet Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e025388","DOI":"10.1136\/bmjopen-2018-025388","article-title":"Cross-sectional study of HPV testing in self-sampled urine and comparison with matched vaginal and cervical samples in women attending colposcopy for the management of abnormal cervical screening","volume":"9","author":"Sargent","year":"2019","journal-title":"BMJ Open"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"100235","DOI":"10.1016\/j.lanepe.2021.100235","article-title":"Clinical performance of high-risk HPV testing on self-samples versus clinician samples in routine primary HPV screening in the Netherlands: An observational study","volume":"11","author":"Inturrisi","year":"2021","journal-title":"Lancet Regional Health-Eur."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Flores, C.A., Gutierrez, G.G., Leon, J.O., Rodriguez, D.C., and S\u00f8rbye, S. (2021). Self-collected versus clinician-collected cervical samples for the detection of HPV infections by 14-type DNA and 7-type mRNA tests. BMC Infect. Dis., 21.","DOI":"10.1186\/s12879-021-06189-2"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1002\/ijc.25144","article-title":"Prevalence of type-specific human papillomavirus in endocervical, upper and lower vaginal, perineal and vaginal self-collected specimens: Implications for vaginal self-collection","volume":"127","author":"Belinson","year":"2010","journal-title":"Int. J. Cancer"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1086\/421916","article-title":"A population-based study of vaginal human papillomavirus infection in hysterectomized women","volume":"190","author":"Castle","year":"2004","journal-title":"J. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"52","DOI":"10.2144\/00291bm09","article-title":"Preparation of PCR-quality mouse genomic DNA with hot sodium hydroxide and tris (HotSHOT)","volume":"29","author":"Truett","year":"2000","journal-title":"Biotechniques"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1002\/jmv.25017","article-title":"Uniplex E6\/E7 PCR method detecting E6 or E7 genes in 39 human papillomavirus types","volume":"90","author":"Okodo","year":"2018","journal-title":"J. Med. Virol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1136\/sextrans-2012-050477","article-title":"A cross-sectional study on the acceptability of self-collection for HPV testing among women in rural China","volume":"88","author":"Guan","year":"2012","journal-title":"Sex. Transm. Infect."},{"key":"ref_19","unstructured":"Koss, L.G., and Melamed, M.R. (2006). Koss\u2019 Diagnostic Cytology and Its Histopathologic Bases, Lippincott Williams & Wilkins."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1097\/gme.0b013e3180587eb5","article-title":"Estrogen modulation of epithelial permeability in cervical-vaginal cells of premenopausal and postmenopausal women","volume":"14","author":"Gorodeski","year":"2007","journal-title":"Menopause"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1136\/sti.70.3.171","article-title":"The detection of HPV DNA, the size of tampon specimens and the menstrual cycle","volume":"70","author":"Fairley","year":"1994","journal-title":"Sex. Transm. Infect."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jcv.2015.09.016","article-title":"Daily self-sampling for high-risk human papillomavirus (HR-HPV) testing","volume":"73","author":"Sanner","year":"2015","journal-title":"J. Clin. Virol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1690","DOI":"10.1038\/sj.bjc.6603151","article-title":"Performance of cytology and human papillomavirus testing in relation to the menstrual cycle","volume":"94","author":"Sherman","year":"2006","journal-title":"Br. J. Cancer"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1002\/ijc.31637","article-title":"Randomised study of HPV prevalence and detection of CIN2+ in vaginal self-sampling compared to cervical specimens collected by medical personnel","volume":"144","author":"Gustavsson","year":"2019","journal-title":"Int. J. Cancer"}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/10\/4\/693\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:41:43Z","timestamp":1760136103000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/10\/4\/693"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,23]]},"references-count":24,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,4]]}},"alternative-id":["microorganisms10040693"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms10040693","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,23]]}}}