Abstract
ABSTRACT
Objective
Anal cancer screening consensus guidelines were released in 2024. Although anal cytology and high‐risk human papillomavirus (HPV) tests are currently performed in a clinic by a healthcare provider, there is increasing interest in providing individuals with the option to collect a sample themselves. Our objective was to compare the performance characteristics and acceptability of a swab inserted at two different depths for anal cytology self‐sampling.
Methods
We recruited sexual and gender minority individuals to complete anal cytology self‐sampling and a survey. Participants were randomized to either a 3‐ or 5‐cm insertion depth, then given a demonstration and a kit to complete onsite in a private bathroom. Cytopathology and reflex HPV testing were conducted.
Results
Fifty individuals completed anal cytology self‐sampling and a post‐swab survey, with 23 participants randomized to the 5‐cm insertion depth and 27 participants randomized to the 3‐cm depth. Although not significant, the proportion of cytologically adequate specimens was higher with a 5‐cm insertion (87.0%, 95% CI 66.4%–97.2%) compared to a 3‐cm insertion (70.4%, 95% CI 49.8%–86.2%). A higher proportion of specimens collected squamocolumnar junction cells with the 5‐cm insertion depth (47.8%, 95% CI 26.8%–69.4%) compared to the 3‐cm insertion (29.6%, 95% CI 13.8%–50.2%) though this difference was non‐significant. Acceptability was high and not associated with insertion depth.
Conclusions
Swabs inserted 5 cm for anal cytology self‐sampling collected a non‐significantly higher proportion of cytologically adequate and squamocolumnar junction cells compared to 3 cm, with no difference in acceptability.
Trial Registration
ClinicalTrials.gov
: NCT07085845