Concordance of human papillomavirus genotypes in mailed home-based self-collected versus clinician-collected anal swabs among sexual and gender minority individuals

Abstract

Abstract Background Home-based self-sampling may be a viable option for anal cancer screening among sexual minority men (SMM). Yet limited research has compared home-based self-collected with clinician-collected anal swabs for human papillomavirus (HPV) genotyping. Methods The Prevent Anal Cancer Self-Swab Study recruited SMM and transgender persons 25 years and over in Milwaukee, Wisconsin, USA to participate in an anal cancer screening study. Participants were randomized to a home or clinic arm. Home-based participants were mailed an anal self-sampling kit to complete and return via postal mail. They were also asked to attend a clinic appointment where a clinician collected an anal swab. Swabs were HPV-genotyped using the SPF10-LiPA25 assay. We analyzed 79 paired self and clinician swabs to determine HPV prevalence, percent agreement, and sensitivity and specificity of the mailed home-based anal self-swab to detect HPV genotypes using the clinician-collected swab as the reference. Results The median number of days between the home and clinic swab was 19 days (range = 2 to 70). HPV was detected in 73.3% of self and 75.0% of clinician anal swabs (p = .99). Prevalence of any HPV, any high-risk HPV, any low-risk HPV, and individual HPV types did not significantly differ between self and clinician anal swabs. Agreement between self and clinician swabs was over 90% for 21 of the 25 HPV genotypes. Mailed home-based self-collected swabs had a sensitivity of 94.1% (95% CI: 82.9 – 99.0) for detection of high-risk HPV versus clinician-collected sampling. Conclusions Mailed home-based self-collected and clinician-collected anal swabs demonstrated high concordance for HPV genotyping.