Accuracy of human papillomavirus testing on self-collected versus clinician-collected samples: a meta-analysis
Abstract
Background Screening for human papillomavirus (HPV) infection is more effective in reducing the incidence of cervical cancer than screening using Pap smears. Moreover, HPV testing can be done on a vaginal sample self-taken by a woman, which offers an opportunity to improve screening coverage. However, the clinical accuracy of HPV testing on self-samples is not well-known. We assessed whether HPV testing on self-collected samples is equivalent to HPV testing on samples collected by clinicians. Methods We identified relevant studies through a search of PubMed, Embase, and CENTRAL. Studies were eligible for inclusion if they fulfilled all of the following selection criteria: a cervical cell sample was self-collected by a woman followed by a sample taken by a clinician; a high-risk HPV test was done on the self-sample (index test) and HPV-testing or cytological interpretation was done on the specimen collected by the clinician (comparator tests); and the presence or absence of cervical intraepithelial neoplasia grade 2 (CIN2) or worse was verified by colposcopy and biopsy in all enrolled women or in women with one or more positive tests. The absolute accuracy for finding CIN2 or worse, or CIN grade 3 (CIN3) or worse of the index and comparator tests as well as the relative accuracy of the index versus the comparator tests were pooled using bivariate normal models and random effect models. Findings We included data from 36 studies, which altogether enrolled 154 556 women. The abso…
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The previous accuracy meta-analysis concluded that hrHPV testing was less sensitive on self samples than on clinician samples, but also found that the reason for lower sensitivity was the use of assays based on signal amplification.
“The previous accuracy meta-analysis concluded that hrHPV testing was less sensitive on self samples than on clinician samples, but also found that the reason for lower sensitivity was the use of assays based on signal amplification.22”
From Detecting cervical precancer and reaching underscreened women by using HPV testing on self samples: updated meta-analyses (2018) · cites this paper as [22]
The Hybrid Capture 2 assay is based on signal amplification techniques and considered less sensitive and specific when used on self-collected samples.
“The Hybrid Capture 2 assay is based on signal amplification techniques and considered less sensitive and specific when used on self-collected samples [10].”
From A community‐based, cross‐sectional study of hr<scp>HPV DNA</scp> self‐sampling‐based cervical cancer screening in rural Karnataka, India (2019) · cites this paper as [10]
For hrHPV DNA testing, self-collected vaginal samples are an acceptable strategy and have shown comparable sensitivity and specificity to clinician-collected samples.
“For hrHPV DNA testing, self-collected vaginal samples are an acceptable strategy and have shown comparable sensitivity and specificity to clinician-collected samples [10].”
From A community‐based, cross‐sectional study of hr<scp>HPV DNA</scp> self‐sampling‐based cervical cancer screening in rural Karnataka, India (2019) · cites this paper as [10]
Cervicovaginal HPV DNA specimens can also be reliably collected by end users themselves, a process known as self-sampling.
“However, cervicovaginal HPV DNA specimens can also be reliably collected by end users themselves—a process known as self-sampling.10–12”
From HPV self-sampling for cervical cancer screening: a systematic review of values and preferences (2021) · cites this paper as [12]
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- Authors
- Arbyn, M., Verdoodt, F., Snijders, P. J. F., Verhoef, V. M. J., Suonio, E., Dillner, L., Minozzi, S., Bellisario, C., Banzi, R., Zhao, F.-H., Hillemanns, P., & Anttila, A.
- Affiliations
- Institut Scientifique de Santé Publique (BE)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Centre international de recherche sur le cancer (FR)
- Karolinska Institutet (SE)
- University of Turin (IT)
- Mario Negri Institute for Pharmacological Research (IT)
- Medizinische Hochschule Hannover (DE)
- Finnish Cancer Registry (FI)
- ORCID
- Venue
- The Lancet Oncology
- Publisher
- Elsevier BV
- Published
- 2014-02
- Volume
- 15
- Issue
- 2
- Pages
- 172-183
- ISSN
- 1470-2045 (ISSN-L)
- OpenAlex
- W2099451994
- Cited by
- 674
- References
- 9
- Citations by year
- 2026: 45 · 2025: 42 · 2024: 58 · 2023: 61 · 2022: 57 · 2021: 41 · 2020: 56 · 2019: 56 · 2018: 66 · 2017: 55 · 2016: 48 · 2015: 58 · 2014: 29 · 2012: 1
- FWCI
- 8.45
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet Oncology (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- seventh Framework Program of DG Research of the European Commission (242061)
- CoheaHr Project (603019)
- Topics
- Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Keywords
- HPV testing, self-collected samples, clinician-collected samples, cervical cancer screening, cervical intraepithelial neoplasia, CIN2+, diagnostic accuracy, sensitivity and specificity, cervical cytology, screening coverage, women's health services, colposcopy, random effects models, subgroup analysis
- MeSH terms
- Biopsy, Uterine Cervical Dysplasia, Uterine Cervical Neoplasms, Colposcopy, Female, Humans, Mass Screening, Predictive Value of Tests, Self Care, Specimen Handling, Reproducibility of Results, Papillomaviridae, Papillomavirus Infections
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