Improvement of gynaecological screening of female renal transplant recipients by self-sampling for HPV detection

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F Hinten, L.B. Hilbrands, K. Meeuwis, M. van Bergen-Verkuyten, B. Slangen, M. van Rossum, J. Rahamat-Langendoen, L. Massuger, J. de Hullu, W. Melchers

Chair(s): dr. Dennis A. Hesselink, internist-nefroloog, Erasmus MC & dr. Marieke Roemeling, internist i.o., UMC Groningen

Wednesday 9 march 2016

15:30 - 15:40h at Zaal 1 & 2

Categories: Parallelsessie (klinisch)

Parallel session: Parallelsessie V - Klinisch

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Background:
Female renal transplant recipients (RTRs) have increased risk for developing human papillomavirus (HPV) related (pre)malignancies of the lower genital tract. Annual cervical screening is advised for RTRs, but the participation rate is low. The aim of this study is to investigate whether HPV self-sampling is suitable for gynaecological screening of RTRs to increase participation rate. 

Methods:
A large prospective cohort study with 253 RTRs, who were transplanted at Radboud university medical center or Maastricht University Medical Centre, was performed.All participants received an Evalyn Brush®, a device for a cervico-vaginal self-sample, and questionnaires were sent to assess the experience with this device. High risk (hr)HPV presence was determined with the high sensitive SPF₁₀-LiPA₂₅ system and clinically validated GP5+/6+ PCR. HrHPV positive tested (SPF₁₀-LiPA₂₅ system) patients underwent gynaecologic examination. 

Results:
More than 90% of the patients rated their experience with the Evalyn Brush® as good to excellent and 77% preferred self-sampling over a physician taken sample. Thirty-five of 217 RTRs (16%) tested hrHPV positive with SPF₁₀- LiPA₂₅ system and 22 (10%) tested positive with the GP5+/6+ PCR. Eleven hrHPV positive patients with SPF₁₀- LiPA₂₅ system had clinically relevant gynaecological abnormalities and they all also tested positive with GP5+/6+ PCR.

Conclusions:
Self-sampling is clinically applicable in gynaecological screening and is preferred by female RTRs. Therefore, self-sampling could be implemented with the aim to increase the participation rate of female RTRs in yearly gynaecological screening.