HPV swab self‐collection and cervical cancer in women who have sex with women

A 39‐year‐old woman was referred for colposcopy with a positive human papillomavirus (HPV) type 16 infection result on a self‐collected HPV vaginal swab. She was asymptomatic and was overdue by many years for cervical screening. Barriers to regular cervical screening were cited as having difficulty with speculum examination and having a female partner, with the subsequent perception that cervical screening was not required. She has no other significant past medical or surgical history. Biopsies obtained at colposcopy demonstrated cervical adenocarcinoma with depth of invasion of 3 mm. Positron emission tomography magnetic resonance imaging demonstrated no locoregional or distant metastatic cervical carcinoma. She underwent open radical hysterectomy, bilateral salpingectomy and bilateral pelvic lymphadenectomy for removal of stage 1b1 cervical adenocarcinoma. Histopathology demonstrated cervical adenocarcinoma with maximal diameter of 12 mm and depth of invasion of 5 mm, with no lymphovascular space invasion, as well as foci of adenocarcinoma in situ and high grade squamous intraepithelial lesions (HSIL). There was no involvement of the parametrium, margins or lymph nodes. Her post‐operative course was complicated by wound infection that resolved with antibiotics. She had no signs or symptoms of cancer recurrence after 6 months of follow‐up.