Improved HPV Detection and Cellular Yield with Flocked Swabs for Vaginal Self-Sampling

As cervical cancer screening programs increasingly incorporate HPV testing on self-collected vaginal samples, it is crucial to use an optimal sample collection device. A study compared the performance of flocked nylon swabs to traditional cotton swabs for HPV detection and cellular recovery from vaginal self-samples. The findings clearly demonstrated significant advantages of flocked swabs over cotton swabs.

Higher HPV Detection Rate

The overall HPV prevalence detected was 38.1% with flocked swabs, compared to only 29.7% with cotton swabs - a statistically significant difference (p=0.006). Detection of the high-risk HPV 16 type was also higher with flocked swabs (15.3% vs 11.5% for cotton), though not statistically significant in this study. These results indicate that flocked swabs are more effective at retrieving sufficient cellular sample for accurate HPV detection and genotyping.

Fewer Invalid HPV Test Results

Inadequate cellular sampling can lead to invalid HPV test results. In this study, a remarkably lower proportion of samples collected with flocked swabs had invalid HPV tests (1.7%) versus cotton swabs (13.1%), a statistically significant difference (p=0.016). Obtaining a valid result is critical, as women with invalid results may require re-screening, reducing program effectiveness. The higher validity rate with flocked swabs can be attributed to their improved cellular yield.

Superior Cellular Retrieval

Both cytofluorometric analysis and cytological cell counting confirmed that flocked swabs collected significantly more vaginal epithelial cells compared to cotton swabs. Cytofluorometry showed a mean of 425,544 cells/mL for flocked swabs versus only 96,727 cells/mL for cotton swabs (p<0.001). Similarly, cytological counting found an average of 17,504 intact cells with flocked swabs compared to 13,130 cells with cotton swabs (p<0.001).

The higher cellular yields are likely due to the unique design of flocked swabs, which have perpendicular nylon fiber strands that more effectively capture and release cells compared to the wrapped fiber design of traditional cotton swabs.

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References

A comparison of cotton and flocked swabs for vaginal self-sample collection