Comparison of External and Internal Site Genital Sampling to Detect High-Risk HPV DNA in Women

Background: Human papillomavirus (HPV), the most common pathogen causing sexually transmitted diseases worldwide, is also an oncogenic virus. Due to the inadequacy of serologic tests in the diagnosis of HPV, NAATs (nucleic acid amplification tests), such as PCR (polymerase chain reaction), represent the gold standard today. Endocervical brush sampling in women has been successfully used for HPV genotyping for many years. The aim of this study was to determine the diagnostic efficacy for PCR HPV genotyping of multi-site samples taken simultaneously with a swab from the external genitalia in addition to endocervical brush sampling in women applying for Hr-HPV screening. Methods: This study included 105 asymptomatic patients who came to the Gynecology Polyclinic of the University of Health Sciences Tepecik Training and Research Hospital between February 2023 and June 2023 for control purposes. Both the samples taken with a brush from the cervical area and the samples taken with a swab from the external genital area were sent to a screening laboratory for testing for Hr-HPV DNA. The samples were analyzed by real time PCR. Results: The success rate of positive detection of swab samples of HPV type 16 was significantly higher, with a difference of 17.6% (p < 0.0001). For HPV type 18, the swab sample had a significantly higher positive detection rate, with a difference of 60.0% (p = 0.002). Conclusions: The results of this study show that HPV genotyping from the external genital area can be performed as an alternative to cervical sampling in sexually active women to increase the reach of a screening program.