Can self vaginal douching for high risk HPV screening replace or assist efficacy of cervical cancer screening?

Objective: To study the accuracy of self vaginal douching and collection for HPV types 16, 18, 31 and 33 in women visiting Thammasat Hospital for the explicit purpose of cervical screening.

Methods: A pelvic examination and Pap smear were performed for all women who came for cervical screening. Specimens were also collected by self vaginal douching before cervical screening and sent to the cell and molecular biology laboratory for analysis of human papillomavirus (HPV) types 16, 18, 31 and 33 using the polymerase chain reaction (PCR).

Results: HPV prevalence was 3.6% overall from 250 women in this study. Twenty-four (9.6%) women had an abnormal cytology screening result. No cancer was found. Four women had a high grade squamous intraepithelial lesion (HSIL) and 14 had a low grade squamous intraepithelial lesion (LSIL) from colposcopic biopsy. Self vaginal douching for HPV 16, 18, 31 and 33 was used to predict abnormal Pap smear. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 12.5%, 97.5%, 33.3% and 91.3%, respectively.

Conclusion: From our analysis of self-vaginal douching for HPV detection using cases from Thammasat university hospital, it cannot replace the Pap smear.