***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND We determined whether testing of self-collected vaginal swabs for human papillomavirus ( HPV ) DNA can be used to screen for cervical disease within internal medicine outpatient clinics . PATIENTS AND METHODS In this prospect i ve study , 560 patients visiting two referral outpatient clinics for internal medicine were asked to take an HPV self- sample .  Acceptability of self sampling , HPV prevalence and cervical intraepithelial neoplasia ( CIN ) detection rate were evaluated . RESULTS 435 women ( 78 % ) performed HPV self-sampling ; 1.5 % considered self-sampling to be difficult . 134 women ( 31 % ) tested positive for high-risk type of HPV . There were significant differences between HPV-positive and -negative women with respect to the following : mean age ( 42 versus 46 years ) , number of women aged < 16 years at first coitus ( 35 % versus 23 % ) and history of drug abuse ( 8.3 % versus 2.6 % ) . Colposcopy could be performed for 70 HPV positive women : CIN 1 - 3 was identified in 24 % . Two of 52 women with HPV-negative results undergoing colposcopy had biopsy-confirmed CIN 1 . Test performance for detection of CIN 2 - 3 after correction for verification bias : sensitivity , 100 % ; specificity , 71 % ; negative predictive value , 100 % ; positive predictive value , 10 % . HPV persistence was associated with a 5.7-fold risk of CIN 2 - 3 detection at follow-up . CONCLUSIONS Self- assessment for HPV DNA is an easy , feasible and well-accepted method for HPV testing and for cervical cancer screening in internal medicine outpatient clinics Background Self-sampling for human papillomavirus ( HPV ) is useful for triage of ASCUS Papanicolaou ( Pap ) smears . Tampons with 10-second cervicovaginal cell exposure can detect HPV but appear to be less efficient than two consecutive swabs . Goal The purpose of this study was to evaluate increased vaginal tampon exposures for detecting high-risk HPV . Study Design This longitudinal cohort study followed women who self- sample d weekly with tampons  for progressively longer periods of time . A tampon was inserted for 10 seconds at the office visit and 1 hour , 4 hours , and overnight for the three subsequent home sample s. Two concurrent swabs were used with each tampon sampling for contemporaneous comparisons . The MY09/MY11 PCR primer system with reverse line blot detection strips was used to detect 18 distinct high-risk HPV types . Results Of the 309 tampons and 618 swabs used at home , 83 % were returned . Among normal women , the 10-second tampon detected fewer with normal histology and high-risk HPV than did its swabs ( P = 0.0412 ) , but the 1-hour , 4-hour , and overnight tampons had high-risk-HPV detection rates equal to their swabs . In women with CIN , all tampons and swabs equally identified those with high-risk HPV . Conclusion Self-sampling for HPV detection is acceptable , feasible , and technically accurate for both tampons with longer cervicovaginal exposures and swabs . The choice of technique is dependent on the woman , her culture , and her clinician OBJECTIVE To explore the acceptability of the self- collection of sample s for human papillomavirus ( HPV ) testing in comparison with that of the Pap test . METHODS The study population consisted of 1069 women 20 years and older who were eligible for coverage through the Mexican Institute of Social Security ( IMSS ) . These women were r and omly selected among participants in a larger study to evaluate the use of HPV testing as an alternative in cervical cancer screening . All participants provided a self-collected vaginal sample for HPV testing according to explicit instructions and underwent a Pap test . Afterwards , each woman was interviewed about her experience and opinion regarding the two procedures . Acceptability was measured by a calculated score based on discomfort , pain , embarrassment , privacy , perception of personal treatment during the Pap test , and underst and ing of how to perform the self-sampling method . RESULTS Ninety-three percent of women experienced sufficient privacy with the Pap test , whereas 98 % of women reported that privacy with the self-sampling procedure was acceptable . The Pap test consistently provoked more discomfort , pain , and embarrassment than self-sampling . Sixty-eight percent of the women who indicated a test preference chose self-sampling .  Preference for this method was positively associated with monthly household income . Women reported a preference for  self-sampling  because it is more comfortable ( 71.2 % ) and causes less embarrassment ( 55.8 % ) . CONCLUSIONS Self-sampling is more acceptable than the Pap test and could improve coverage rates of early detection programs . The incorporation of self-collected sample s to detect HPV could encourage participation in screening programs among those women who reject the Pap test because of the necessary pelvic examination OBJECTIVE The purpose of this study was to compare the high-risk human papillomavirus detection rates from self- sample d swabs and tampons with st and ard clinician-directed speculum sampling and to assess women  's acceptance of self-sampling methods . STUDY DESIGN One hundred three women who required a colposcopy underwent order r and omization of the human papillomavirus sampling technique .  Kappa and McNemar test statistical results were used to measure the agreement between clinician-directed  and self-sampling  techniques for high-risk types of human papillomavirus and the acceptance of self-sampling techniques . RESULTS All self-directed samplings were equivalent to clinician sampling for all cervical intraepithelial neoplasia disease states . High-risk human papillomavirus was detected by self- and clinician-directed methods in 83 % of the women with cervical intraepithelial neoplasia , grade 2/3 . The 2 sequential swabs trend toward better detection of high-risk types of human papillomavirus than all other techniques for women with normal histologic factors ( P = .0736 , by McNemar 's chi2 test ) . Ninety-four percent of women would accept self-sampling for their yearly cervical screen . CONCLUSION Self-sampling is equivalent to clinician sampling for the detection of high-risk human papillomavirus and is acceptable to women as a yearly screen 
    Output:
    
Vaginal human papillomavirus DNA self-sampling is generally well received among women .
However , the possibility of selection bias and survey instrument measurement error may have led to an overestimate of women 's favorable opinions for self-sampling .