Experience of Cervical Cytology and High-Risk HPV Testing (Physician vs Self-Collected) for Primary Cervical Cancer Screening in an Urban Hospital of Thailand

Sep 23, 2026

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Objective: explore experiences with conventional Pap smear (CPS), physician-collected HPV (pHPV), and self-collected HPV testing (sHPV) for cervical cancer screening in Thailand’s north-eastern general population. Methods: a retrospective study of women attending a gynecology and colposcopy clinic between January 2020 and December 2023; participants received counselling before choosing CPS, pHPV, or sHPV. Records reviewed included age, parity, screening and colposcopy results, and treatment. Results: 5,984 women were enrolled; positivity rates and return-to-colposcopy differed by method. Conclusion: primary HPV and CPS showed comparable reliability and acceptability, while missing follow-up with sHPV reflex cytology/colposcopy was a key concern.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages5

Reading Time13 min

AccessFree to download

Abstract

Objective

Methods

Results

Conclusion

Introduction

Global burden and screening rationale

Evolution of screening methods

Guidelines and recommendations

Role of self-collection in HPV testing

RESEARCH ARTICLE Editorial Process: Submission:11/19/2024 Acceptance:04/14/2025 Experience of Cervical Cytology and High-Risk HPV Testing (Physician vs Self-Collected) for Primary Cervical Cancer Screening in an Urban Hospital of Thailand AdisakWaiketkarn1, Kanokwan Promchit2 *, SasipimThitvirachawat2, Komsun Suwannarurk2 Abstract Objective: To explore the experience of conventional Pap smear (CPS), physician-collected HPV (pHPV) and selfcollected HPV test (sHPV) for cervical cancer (CC) screening in the general population in the north-eastern region of Thailand. Methods: A retrospective study was conducted among women who visited the gynecology and colposcopy clinic in Kuchinarai Crown Prince Hospital for CC screening between January 2020 and December 2023. Participants received counselling before choosing between CPS, pHPV, and sHPV testing. Data reviewed from medical records included age, parity, CC screening results, colposcopy results, and treatment. Results: A total of 5,984 women were enrolled in the study. There were 1,727, 2,962 and 1,295 cases in the CPS, pHPV, and sHPV, respectively. The average age of participants was 40.6, 49.5 and 47.6 years old in the CPS, pHPV, and sHPV, respectively. Percentage of multiparous participants were 86.3, 94.4 and 93.8 in CPS, pHPV and sHPV, respectively. Positive test results from the CPS, pHPV, and sHPV were 1.4, 5.7, and 6.8 percent, respectively with statistical significance. Return to colposcopy ofCPS (62.5%) was highest and followed by pHPV (35.3%) and sHPV (18.2%) groups with statistical significance. Detection rate of CIN2+/CIN 3+ were 0.1/0.1, 0.5/0.4 and 0.2/0.2 percent from CPS, sHPV, and sHPV groups, respectively with statistical significance. Conclusion: Primary HPV and CPS testing had comparable reliability and acceptability for CC screening among Thai women. High missing rate for reflexed cytology or colposcopy ofsHPV was a major issue. Keywords: Pap smear-HPV-self-collected-physician-collected-cervical cancer Asian Pac J Cancer Prev, 26 (4), 1401-1405 Introduction Cervical cancer (CC) is the fourth most common cancer among women globally. In 2022, there was an estimate of 662,301 new cases and 348,874 deaths. Almost 90 percent of the cases and deaths occurred in low-and middle-income countries [1] . In Thailand, CC isthe second most common cancer among women aged between 15 and 44 years old [2]. Currently, the incidence rate ofCC is declining since it is one of the most preventable and treatable types of cancer [1]. The human papillomavirus (HPV) is the most common pathogen responsible for precancerous and cancerous cervical lesions. Over 100 HPV types have been identified, but only up to 15 anogenital types maybe referred to as oncogenic with HPV 16 and 18 being known as the high-risk types (hrHPV) most associated with CC [3]. Therefore, screening is key to early detection and diagnosis of the disease. Nowadays, CC screening tools consist of cervical cytology, HPV testing, and combined testing methods. Over 90 years ago, conventional Pap smear (CPS), a cervical cytology-based screening tool, was first introduced and became widely used for screening and early detection of precancerous cervical lesions. Later in the 1990s, liquid-based cytology testing was developed. Rather than smearing the sample onto a slide as in CPS, the liquid-based method involves transferring the sample into a liquid medium. This filter out blood and debris and increases cellular yield, which was then automatical processed. In 2003, a combination of hrHPV testing with cytology testing was approved, increasing sensitivity to 100 percent and allowing for longer intervals between screenings [4] . In 2020, the American Society of Colposcopy and Cervical Pathology (ASCCP) issued a risk-based management guideline and recommendations for primary HPV screening [5] . In 2021, the World Health Organization (WHO) strongly recommended the use of 1Department of Obstetrics and Gyna

FAQs

What screening methods were compared in this study?

The study compared conventional Pap smear (CPS), physician-collected HPV testing (pHPV), and self-collected HPV testing (sHPV) for primary cervical cancer screening.

How was the study conducted and what data were reviewed?

A retrospective study enrolled women visiting the gynecology and colposcopy clinic from January 2020 to December 2023. Medical records provided age, parity, screening results, colposcopy results, and treatment.

What was the main conclusion about reliability and acceptability?

Primary HPV testing and CPS showed comparable reliability and acceptability for cervical cancer screening among Thai women.

What issue was highlighted regarding sHPV follow-up?

A high missing rate for reflexed cytology or colposcopy after sHPV was identified as a major problem.

Sep 23, 2026

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