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Background  Modern cervical cancer screening increasingly relies on the use of molecular techniques detecting high-risk oncogenic human papillomavirus (hr-HPV). A major challenge for developing countries like Ghana has been the unavailability and costs of HPV DNA-based testing. This study compares the performance of  care HPV, a semi-rapid and affordable qualitative detection assay for 14 hr-HPV genotypes, with HPV genotyping, for the detection of cytological cervical squamous intraepithelial lesions (SIL).    Methods  A study comparing between frequency matched HIV-1 seropositive and HIV-seronegative women was conducted in the Cape Coast Teaching Hospital, Ghana. A systematic sampling method was used to select women attending clinics in the hospital. Cervical samples were tested for HPV by  care HPV and Anyplex-II HPV28 genotyping assay, and by conventional cytology.    Results  A total of 175 paired results (94 from HIV-1 seropositive and 81 from HIV-seronegative women) were analyzed based on the ability of both tests to detect the 14 hr-HPV types included in the  care HPV assay. The inter-assay concordance was 94.3% (95%CI: 89.7–97.2%, kappa = 0.88), similar by HIV serostatus. The  care HPV assay was equally sensitive among HIV-1 seropositive and seronegative women (97.3% vs. 95.7%,  p  = 0.50) and slightly more specific among HIV-seronegative women (85.0% vs. 93.1%,  p  = 0.10).  care HPV had good sensitivity (87.5%) but low specificity (52.1%) for the detection of low SIL or greater lesions, but its performance was superior to genotyping (87.5 and 38.8%, respectively). Reproducibility of  care HPV, tested on 97 samples by the same individual was 82.5% (95%CI: 73.4–89.4%).    Conclusions  The performance characteristics of  care HPV compared to genotyping suggest that this simpler and cheaper HPV detection assay could offer a suitable alternative for HPV screening in Ghana.

gynecologic oncology research and practice

Options in human papillomavirus (HPV) detection for cervical cancer screening: comparison between full genotyping and a rapid qualitative HPV-DNA assay in Ghana