Offering HPV self-sampling kits: an updated meta-analysis of the effectiveness of strategies to increase participation in cervical cancer screening

Costa, Stefanie; Verberckmoes, Bo; Castle, Philip E.; Arbyn, Marc

doi:10.1038/s41416-022-02094-w

Cited by 141Cervical Cancer and HPV ResearchWomen's cancer prevention and managementGlobal Cancer Incidence and Screening

Offering HPV self-sampling kits: an updated meta-analysis of the effectiveness of strategies to increase participation in cervical cancer screening

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Costa, Stefanie, Verberckmoes, Bo, Castle, Philip E., Arbyn, Marc·2023·British Journal of Cancer

DOI 10.1038/s41416-022-02094-wPMC PMC9977737

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Abstract

Background Human papillomavirus (HPV) testing on self-samples represents a great opportunity to increase cervical cancer screening uptake among under-screened women. Methods A systematic review and meta-analysis on randomised controlled trials (RCTs) were performed to update the evidence on the efficacy of strategies for offering self-sampling kits for HPV testing compared to conventional invitations and to compare different self-sampling invitation scenarios. Four experimental invitational scenarios were considered. Women in the control group were invited for screening according to existing practice: collection of a cervical specimen by a healthcare professional. Random-effects models were used to pool proportions, relative participation rates and absolute participation differences. Results Thirty-three trials were included. In the intention-to-treat analysis, all self-sampling invitation scenarios were more effective in reaching under-screened women compared to controls. Pooled participation difference (PD) and 95% confidence interval (CI) for experimental vs. control was 13.2% (95% CI = 11.0-15.3%) for mail-to-all, 4.4% (95% CI = 1.2-7.6%) for opt-in, 39.1% (95% CI = 8.4-69.9%) for community mobilisation & outreach and 28.1% (23.5-32.7%) for offer at healthcare service. PD for the comparison opt-in vs. mail-to-all, assessed in nine trials, was -8.2% (95% CI = -10.8 to -5.7%). Discussion Overall, screening participation was higher among women invited for self-sampling compared to control, regardless of the invitation strategy used. Opt-in strategies were less effective than send-to-all strategies.

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HPV self-sampling increases screening participation rates.
“HPV self-sampling increases the screening participation rates [12] and thus increases the screening coverage [13].”
From Performance of HPV Self-Sample Collected by a Novel Kit in Comparison with Clinician Collected Sample for Cervical Cancer Screening (2024) · cites this paper as [12]

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[6]IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. IARC monographs on the evaluation of carcinogenic risks to humans. Human papillomaviruses. Vol. 90. Lyon, FR: International Agency for Research on Cancer; 2007.

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A Mail-Based HPV Self-Collection Program to Increase Cervical Cancer Screening in Appalachia: Results of a Group Randomized Trial
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Equivalent Clinical Accuracy of Human Papillomavirus DNA Testing Using Cobas 4800 and 6800 Human Papillomavirus Systems in Paired Urine and Cervical Samples
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Acceptability to Healthcare Professionals of Home-Based HPV Self-Sampling for Cervical Screening: A French Qualitative Study Conducted in an Area with Low Access to Health Services
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Uptake and performance of self-collection offered through primary care to all eligible participants in a national cervical screening programme in Australia: a retrospective cohort study
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Tatar, O., Haward, B., Perez, S., Zhu, P., Brotherton, J. M. L., Decker, K., Lofters, A., Mayrand, M., McBride, E., Ogilvie, G. S., et al. (2024) · The Lancet Regional Health - Americas · doi:10.1016/j.lana.2024.100901 · Cited by 9 · see citing works
Human Papillomavirus ( HPV ) Screening With Universal Access to Vaginal Self‐Testing: Outcomes of an Implementation Trial
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‘I Don't Think There Is a One‐Size‐Fits‐All’: A Qualitative Study Exploring Healthcare Professional and Service Provider Perspectives of Using Innovative Models of Cervical Screening to Improve Equitable Access to Self‐Collection
Bavor, C., Saunders, T., Wolfe, M., Smith, M. A., Creagh, N. S., Bateson, D. J., Kelly‐Hanku, A., Jops, P., Saville, M., Taylor, N., et al. (2025) · Cancer Medicine · doi:10.1002/cam4.70981 · Cited by 6 · see citing works
Culturally Competent Education and Human Papillomavirus Self-Sampling Achieves Healthy People 2030 Cervical Screening Target Among Low-Income Non-Hispanic Black and Hispanic Women
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Self-citation
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Agreement Between High-Risk Human Papillomavirus Testing in Paired Self-Collected and Clinician-Collected Samples from Cervical Cancer Screening in Spain
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Advancing the elimination of cervical cancer across Africa
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Implementation of Human Papillomavirus Self-Collection and Barriers to Follow-Up Among Unhoused Individuals in Texas
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Nurse Roles Implementing the Choice for Self‐Collection Cervical Screening in Rural Settings: A Qualitative Study Following National Policy Change
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Interval cervical cancers after self-sampling for human papillomavirus in the general population
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National Outcomes of Increasing Cervical Cancer Screening in Federally Qualified Health Centers
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Comparative performance of HPV self-sampling and conventional screening methods: A systematic review and bivariate meta-analysis
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Authors: Costa, S., Verberckmoes, B., Castle, P. E., & Arbyn, M.
Affiliations: Sciensano (Belgium) (BE)
Ghent University Hospital (BE)
National Cancer Institute (US)
Ghent University (BE)
Corresponding author: Arbyn, Marc
ORCID: Costa, Stefanie
Verberckmoes, Bo
Castle, Philip E.
Arbyn, Marc
Venue: British Journal of Cancer
Publisher: Springer Science and Business Media LLC
Published: 2022-12-14
Volume: 128
Issue: 5
Pages: 805-813
ISSN: 0007-0920 (ISSN-L)
1532-1827
DOI: 10.1038/s41416-022-02094-w
PMC: PMC9977737
OpenAlex: W4311399768
Cited by: 139
References: 63
Citations by year: 2026: 44 · 2025: 45 · 2024: 38 · 2023: 12
FWCI: 3.77
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.springernature.com/gp/researchers/text-and-data-mining (tdm)
www.springernature.com/gp/researchers/text-and-data-mining (vor)
Locations: British Journal of Cancer (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Ghent University Academic Bibliography (Ghent University) (submittedVersion)
Funders: EC | Horizon 2020 Framework Programme (825747, 847845)
U.S. Department of Health & Human Services | NIH | NCI | Division of Cancer Epidemiology and Genetics, National Cancer Institute (ZIACP101237-01)
VALHUDES researcher-induced frameworks for comparison and validation of HPV tests used on clinician-collected and self-collected samples
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
Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
Keywords: HPV self-sampling, cervical cancer screening, screening uptake, community mobilization, underscreened women, HPV testing
MeSH terms: Uterine Cervical Neoplasms, Female, Humans, Mass Screening, Self Care, Specimen Handling, Vaginal Smears, Papillomaviridae, Papillomavirus Infections, Early Detection of Cancer

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Offering HPV self-sampling kits: an updated meta-analysis of the effectiveness of strategies to increase participation in cervical cancer screening

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