HPV self-sampling for cervical cancer screening: a systematic review of values and preferences

Nishimura, Holly; Yeh, Ping Teresa; Oguntade, Habibat; Kennedy, Caitlin E; Narasimhan, Manjulaa

doi:10.1136/bmjgh-2020-003743

Cited by 222Cervical Cancer and HPV ResearchWomen's cancer prevention and managementReproductive tract infections research

HPV self-sampling for cervical cancer screening: a systematic review of values and preferences

Open access

Nishimura, Holly, Yeh, Ping Teresa, Oguntade, Habibat, Kennedy, Caitlin E, Narasimhan, Manjulaa·2021·BMJ Global Health

DOI 10.1136/bmjgh-2020-003743PMC PMC8137189

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Abstract

Introduction: The WHO recommends human papillomavirus (HPV) cervical self-sampling as an additional screening method and HPV DNA testing as an effective approach for the early detection of cervical cancer for women aged ≥30 years. This systematic review assesses end user’s values and preferences related to HPV self-sampling. Methods: We searched four electronic databases (PubMed, Cumulative Index to Nursing and Allied Health Literature, Latin American and Caribbean Health Sciences Literature and Embase) using search terms for HPV and self-sampling to identify articles meeting inclusion criteria. A standardised data extraction form was used to capture study setting, population, sample size and results related to values and preferences. Results: Of 1858 records retrieved, 72 studies among 52 114 participants published between 2002 and 2018 were included in this review. Almost all studies were cross-sectional surveys. Study populations included end users who were mainly adolescent girls and adult women. Ages ranged from 14 to 80 years. Most studies (57%) were conducted in high-income countries. Women generally found HPV self-sampling highly acceptable regardless of age, income or country of residence. Lack of self-confidence with collecting a reliable sample was the most commonly cited reason for preferring clinician-collected samples. Most women preferred home-based self-sampling to self-sampling at a clinic. The cervical swab was the most common and most accepted HPV DNA sampling device. Conclusions: HPV self-sampling is generally a highly accepted method of cervical cancer screening for end users globally. End user preferences for self-sampling device, method and setting can inform the development of new and expanded interventions to increase HPV screening.

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review synthesizes 72 studies among 52,114 participants on end users’ values and preferences for HPV self-sampling for cervical cancer screening. It finds HPV self-sampling is generally highly acceptable globally, with most women preferring self-sampling over clinician sampling, though confidence in sample accuracy and access to a provider remain concerns.

Key findings

Across 72 studies among 52,114 participants published between 2002 and 2018, with ages ranging from 14 to 80 years, HPV self-sampling was generally highly acceptable regardless of age, income or country of residence; 57% of participants were from high-income countries.
Most end users preferred self-sampling over clinician sampling, citing less pain or physical discomfort, ease of use, convenience, privacy, and less embarrassment or anxiety; lack of self-confidence in collecting a reliable sample was the most commonly cited reason for preferring clinician-collected samples.
Most women preferred home-based self-sampling to self-sampling at a clinic; the cervical swab was the most common and most accepted HPV DNA sampling device.
Device preference varied: in rural Gambian women, acceptability was over 70% for all methods but preference was cervical swab 97.1%, tampon 84.4%, and clinician cervical brush 72.4%; among HIV-positive South African women, 51% preferred the cervical brush, 31% the tampon, and 18% the lavage sampler. For urine self-sampling, 95% of Micronesian women were comfortable with the urine test versus 82% for Pap smear, but more preferred clinician Pap smear (44.2%) over self-sampling (38.8%).

Methods

Systematic review conducted according to PRISMA; searched PubMed, Cumulative Index to Nursing and Allied Health Literature, Latin American and Caribbean Health Sciences Literature, and Embase through 19 October 2018, plus hand-searching and secondary searching; included qualitative and quantitative studies of cervicovaginal or urine HPV self-sampling that measured acceptability or setting preference.
Included 72 unique studies with 52,114 participants; two reviewers independently extracted data using a standardised form, resolved differences through consensus, and stratified findings by age, location, self-sampling device, setting, and subpopulation; quality was assessed with a matrix modified from the Evidence Project risk of bias tool and CASP checklist.

Limitations

Stated: conference abstracts and grey literature were excluded, so findings may not fully represent the literature; diversity of measures used to assess values and preferences made comparisons across studies difficult.
Stated in quality assessment: common issues were sampling/selection bias (27 articles), lack of validation of survey measures, and lack of transferability (32 articles); only 3 of 72 studies were conducted in low-income countries.
Evident from the text: almost all studies were cross-sectional surveys, and 57% of participants were from high-income countries, limiting generalisability to low-resource settings and causal inference.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1136/bmjgh-2020-003743

Cites

99 of 99 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

26 of 39 cited sources checked · 16 supported · 2 flagged · accuracy not yet measured

Premisecitation
Among AGYW attending a teen health centre in the USA, most participants expressed a preference for clinician sampling.
“However, most participants expressed a preference for clinician sampling.”
Quote in the paperNot a substantial claim1 of 1 sources checked
- cites [63] source
  The Methods (Study Design; page unavailable) describe a nationwide online panel of lesbian and bisexual women aged 21–26, not attendees of a teen health centre. The Results (HPV Self-Testing; page unavailable) report that 44% would rather go to a doctor for screening, not most participants; 51% were willing to self-test at home. The paper did not directly measure a preference between clinician and self-sampling. (LLM, conf=0.88)
  Checked by a reasoning model — may be wrong.
  Experimental — accuracy not yet measured
Premisecitation
HPV DNA self-sampling has been associated with improved participation in cervical cancer screening studies in low-income and middle-income countries.
“and has been associated with improved participation in cervical cancer screening studies in low-income and middle-income countries.14”
Quote in the paperNot a substantial claim1 of 1 sources checked
- cites [14] source
  The Abstract (page not specified) reports improved screening participation with self-collected HPV testing. But it says the ten studies reviewed were in Europe and North America, so its findings do not establish improved participation in studies in low- and middle-income countries. (LLM, conf=0.91)
  Experimental — accuracy not yet measured
Premisecitation
In a study of Swedish women with CIN, 85% of participants rated self-sampling procedures (urine and cervical swab) as easy.
“In a study of Swedish women with CIN, 85% of participants rated self-sampling procedures (urine and cervical swab) as easy”
Quote in the paperNot a substantial claim1 of 1 sources checked
- cites [66] Andersson, 2018, Is self-sampling to test for high-risk papillomavirus an acceptable option among women who have been treated for high-grade cervical intraepithelial neoplasia?, PLoS One source
  The Results section reports that over 85% of participants considered self-collection easy to carry out. The Methods section says participants self-collected urine and vaginal-fluid samples; cervical scrape samples were collected by clinicians, not by self-sampling. Thus the percentage is supported, but the claim's description of a self-collected cervical swab is not. (LLM, conf=0.87)
  Experimental — accuracy not yet measured
Premisecitation
In the same sample of Micronesian women, more women preferred a clinician to perform a Pap smear (44.2%) over self-sampling (38.8%).
“Despite higher ratings for urine self-sampling, more women preferred a clinician to perform a Pap smear (44.2%) over self-sampling (38.8%) because they valued the knowledge and expertise of the clinician.”
Quote in the paperNot a substantial claim1 of 1 sources checked
- cites [30] Sy, 2017, Acceptability and feasibility of a community based participatory research project comparing cytology and urine HPV DNA testing for cervical cancer screening in YAP, Federated states of Micronesia, Cancer Epidemiol source
  The women research participant survey (Results §3.1; page not provided) reports that 44.2% preferred a doctor or nurse to perform the Pap smear, compared with 38.3% who preferred providing their own urine sample—not 38.8%. The focus group findings (Results §3.3; page not provided) link the preference for clinician collection to participants’ confidence in skilled, knowledgeable screeners. (LLM, conf=0.93)
  Experimental — accuracy not yet measured
Premisecitation
In a sample of Micronesian women, 95% of participants said they were comfortable with the urine test compared with 82% for the Pap smear.
“In a sample of Micronesian women, 95% of participants said they were comfortable with the urine test compared with only 82% for the Pap smear.”
Quote in the paperNot a substantial claim1 of 1 sources checked
- cites [30] Sy, 2017, Acceptability and feasibility of a community based participatory research project comparing cytology and urine HPV DNA testing for cervical cancer screening in YAP, Federated states of Micronesia, Cancer Epidemiol source

Premisecitation
Among South African students aged 16-22 years, 56% preferred self-sampling over clinician sampling.
“Among South African students aged 16–22 years, 56% preferred self-sampling (56%) over clinician sampling.”
Quote in the paperNot a substantial claim1 of 1 sources checked
- cites [54] Mbatha, 2017, Self-Sampling for human papillomavirus testing among rural young women of KwaZulu-Natal, South Africa, BMC Res Notes source
Premisecitation
In a sample of HIV-positive and HIV-negative women from northern Brazil, 87% found cervicovaginal sampling for HPV DNA acceptable.
“One study surveyed a sample of HIV-positive and HIV-negative women from northern Brazil, reporting that 87% of women found cervicovaginal sampling for HPV DNA acceptable.”
Quote in the paperNot a substantial claim1 of 1 sources checked
- cites [60] Rodrigues, 2018, Cervico-Vaginal self-collection in HIV-infected and uninfected women from Tapajós region, Amazon, Brazil: high acceptability, hrHPV diversity and risk factors, Gynecol Oncol source
Findingcitation
Other studies found that older women were more likely to prefer self-sampling over clinician sampling.
“Other studies found that older women were more likely to prefer self-sampling over clinician sampling.”
Quote in the paperNot a substantial claim1 of 3 sources checked
- cites [24] Fargnoli, 2015, To what extent will women accept HPV self-sampling for cervical cancer screening? A qualitative study conducted in Switzerland, Int J Womens Health source
  The Results report a generational difference: some older women were more in favor of self-sampling than younger women, particularly after a bad experience with pelvic examinations. But the qualitative finding does not establish that older women generally preferred self-sampling over clinician sampling; the Conclusion says most participants preferred a gynecological visit. Page numbers are unavailable in our copy. (LLM, conf=0.84)
  Experimental — accuracy not yet measured
- cites [40] Wong, 2018, Can human papillomavirus DNA self-sampling be an acceptable and reliable option for cervical cancer screening in female sex workers?, Cancer Nurs source
- cites [42] Ilangovan, 2016, Acceptability and feasibility of human papilloma virus self-sampling for cervical cancer screening, J Womens Health source
Premisecitation
In that study, women across all study sites preferred to conduct self-sampling in a clinic setting rather than at home so that a provider could clarify questions or do the test if needed.
“Women across all study sites preferred to conduct self-sampling in a clinic setting rather than at home so that a provider could clarify questions or do the test if needed.”
Quote in the paperNot a substantial claim1 of 1 sources checked
- cites [70] source
  The Results section (‘Preference of self sampling at a clinic’; page unavailable) reports that some respondents preferred the clinic because a provider could collect the sample if needed, among other reasons. The Abstract reports that most women preferred clinic-based screening, but does not establish that preference separately for every site. The Discussion attributes the specific reason that a provider could clarify questions to women in a separate Mexican study, not to participants across this paper’s study sites. (LLM, conf=0.88)
  Experimental — accuracy not yet measured
Premisecitation
In an online survey of lesbian and bisexual AGYW in the USA, 51% reported willingness to self-sample at home.
“In an online survey of lesbian and bisexual AGYW in the USA, 51% participants reported willingness to self-sample at home.”
Quote in the paperNot a substantial claim1 of 1 sources checked
- cites [63] source
Premisecitation
In that study of Swedish women with CIN, 74% said they could see themselves self-sampling at home.
“74% said they could see themselves self-sampling at home.”
Quote in the paperNot a substantial claim1 of 1 sources checked
- cites [66] Andersson, 2018, Is self-sampling to test for high-risk papillomavirus an acceptable option among women who have been treated for high-grade cervical intraepithelial neoplasia?, PLoS One source
Premisecitation
Some transmale participants cited feelings of gender dysphoria and difficulty positioning the body or swab for self-sampling as challenges of self-sampling.
“Some participants cited feelings of gender dysphoria and difficulty positioning the body or swab for self-sampling as challenges of self-sampling.”
Quote in the paperNot a substantial claim1 of 1 sources checked
- cites [62] Reisner, 2018, Test performance and acceptability of self- versus provider-collected swabs for high-risk HPV DNA testing in female-to-male trans masculine patients, PLoS One source
Premisecitation
Among transmales who had undergone both self-sampling and clinician sampling for HPV DNA, 90% expressed a preference for self-sampling.
“Among transmales who had undergone both self-sampling and clinician sampling for HPV DNA, 90% expressed a preference for self-sampling citing privacy, ease and self-empowerment as reasons for their preference.”
Quote in the paperNot a substantial claim1 of 1 sources checked
- cites [62] Reisner, 2018, Test performance and acceptability of self- versus provider-collected swabs for high-risk HPV DNA testing in female-to-male trans masculine patients, PLoS One source
Premisecitation
In that Brazilian sample, a greater proportion of HIV-positive women reported acceptability (97%) than HIV-negative women (84%).
“A greater proportion of HIV-positive women reported acceptability (97%) than HIV-negative women (84%).”
Quote in the paperNot a substantial claim1 of 1 sources checked
- cites [60] Rodrigues, 2018, Cervico-Vaginal self-collection in HIV-infected and uninfected women from Tapajós region, Amazon, Brazil: high acceptability, hrHPV diversity and risk factors, Gynecol Oncol source
  The Results section (‘Acceptability of CVSC’) reports higher acceptance among HIV-infected women than HIV-uninfected women, but gives the figures as 95% (39/41) and 84% (94/112), respectively. The claimed 97% for HIV-positive women does not match the reported acceptability figure. (LLM, conf=0.92)
  Experimental — accuracy not yet measured
Findingown data
The review identified 72 unique studies presenting values and preferences data on HPV self-sampling.
“we identified 72 unique studies presenting values and preferences data on HPV self-sampling”
Quote in the paperSubstantial claim
Findingcitation
Even among end users that preferred self-sampling, many lacked confidence in the accuracy of self-sampled specimens.
“Even among end users that preferred self-sampling, many lacked confidence in accuracy of self-sampled specimens.24 25 27–29 33 35–37 39–41 47 49 52–55 57 59 62–66 69 70 73 78–80 85 94”
Quote in the paperNot a substantial claim
Findingcitation
In nine studies, end users preferred clinician sampling over self-sampling.
“In nine studies, end users preferred clinician sampling over self-sampling.25 28 30 53 57 64 73 76 87”
Quote in the paperNot a substantial claim
Findingcitation
Ability to perform the test in private was among the most frequently cited reasons for preferring self-sampling over clinician sampling.
“The most frequently cited reasons for preferring self-sampling over clinician sampling were less pain or physical discomfort,29 31 32 34–37 39 43 44 52 57 58 65 70 71 73 77–80 86 88–91 93–95 ease of use, convenience, ability to perform the test in private28 29 31–33 36 39 42 46 52 57 59 62 74 77 81 89 90 94 and less embarrassment or anxiety.”
Quote in the paperNot a substantial claim
Findingcitation
Less pain or physical discomfort was among the most frequently cited reasons for preferring self-sampling over clinician sampling.
“The most frequently cited reasons for preferring self-sampling over clinician sampling were less pain or physical discomfort,29 31 32 34–37 39 43 44 52 57 58 65 70 71 73 77–80 86 88–91 93–95 ease of use, convenience, ability to perform the test in private28 29 31–33 36 39 42 46 52 57 59 62 74 77 81 89 90 94 and less embarrassment or anxiety.”
Quote in the paperNot a substantial claim
Findingcitation
Self-sampling was generally highly acceptable regardless of age, income or country of residence.
“Self-sampling was generally highly acceptable regardless of age, income or country of residence.”
Quote in the paperSubstantial claim
Findingcitation
Ease of use and convenience were among the most frequently cited reasons for preferring self-sampling over clinician sampling.
“The most frequently cited reasons for preferring self-sampling over clinician sampling were less pain or physical discomfort,29 31 32 34–37 39 43 44 52 57 58 65 70 71 73 77–80 86 88–91 93–95 ease of use, convenience, ability to perform the test in private28 29 31–33 36 39 42 46 52 57 59 62 74 77 81 89 90 94 and less embarrassment or anxiety.”
Quote in the paperNot a substantial claim
Findingreasoning
Concerns about confidence in self-sampling were expressed in both high-income and low-income settings.
“These concerns were expressed in both high-income and low-income settings.”
Quote in the paperNot a substantial claim
Findingcitation
Less embarrassment or anxiety was among the most frequently cited reasons for preferring self-sampling over clinician sampling.
“The most frequently cited reasons for preferring self-sampling over clinician sampling were less pain or physical discomfort,29 31 32 34–37 39 43 44 52 57 58 65 70 71 73 77–80 86 88–91 93–95 ease of use, convenience, ability to perform the test in private28 29 31–33 36 39 42 46 52 57 59 62 74 77 81 89 90 94 and less embarrassment or anxiety.”
Quote in the paperNot a substantial claim
Findingcitation
Thirty-two articles reported that their results were not transferable to the study population or entire geographic population.
“Thirty-two articles reported that their results were not transferable to the study population or entire geographic population.25 26 29 35–40 46 53 57 59 62 64–67 70 72 75 77–81 87 88 91 93–95”
Quote in the paperNot a substantial claim
Findingcitation
One study acknowledged that participants self-selected to participate with the knowledge that self-collection would be a critical component of the study, so there may have been some selection bias towards acceptability of the self-test.
“one study acknowledged that participants self-selected to participate with the knowledge that self-collection would be a critical component of the study, so there may have been some selection bias towards acceptability of the self-test.43”
Quote in the paperNot a substantial claim
Findingcitation
Nine studies employed a qualitative design, specifically in-depth interviews and focus group discussions, to explore women's preferences related to HPV self-sampling.
“Nine studies employed a qualitative design, specifically in-depth interviews and focus group discussions, to explore women’s preferences related to HPV self-sampling.24–32”
Quote in the paperNot a substantial claim
Findingcitation
Fourteen studies specifically targeted women who were under-screened or never screened for cervical cancer.
“Fourteen studies specifically targeted women who were under/never screened for cervical cancer.24 26 30 31 37 38 41–48”
Quote in the paperNot a substantial claim
Findingown data
Twenty-seven articles reported sampling or selection bias as a limitation of the study.
“Twenty-seven articles reported sampling or selection bias as a limitation of the study.26 27 29 35–37 39 40 43 46 52 54 57 59 61–64 66 70 83 87 89 91 93 95 96”
Quote in the paperNot a substantial claim
Findingcitation
Across most of the studies asking end users' preference regarding self-sampling versus clinician sampling for HPV DNA, most end users chose self-sampling.
“Across most of the studies asking end users’ preference regarding self-sampling versus clinician sampling for HPV DNA, most end users chose self-sampling.29 35 36 42 43 52 54 56 58 59 62 65 68 69 71 74 77–86 88 89 91–93 95”
Quote in the paperSubstantial claim
Findingreasoning
End users expressed greater confidence in the clinician's ability to collect the specimen properly.
“End users expressed greater confidence in the clinician’s ability to collect the specimen properly.”
Quote in the paperNot a substantial claim
Findingcitation
In clinical settings, end users cited the important role of a trusted healthcare provider in fielding questions and providing reassurance that sampling was done correctly.
“In clinical settings, end users cited the important role of a trusted healthcare provider in fielding questions and providing reassurance that sampling was done correctly.27 30 47 70”
Quote in the paperNot a substantial claim
Findingcitation
In 21 studies, end users self-sampled from their homes.
“In 21 studies, end users self-sampled from their homes.26 33 35–38 43 45 46 49 58 59 69 72 74 81 82 84 85 92 93”
Quote in the paperNot a substantial claim
Findingcitation
In a sample of rural Gambian women, all three methods (self-sampling using cervical swab, self-sampling using tampon, and clinician sampling using cervical brush) were found acceptable by more than 70% of participants.
“Though all three methods were found to acceptable by more than 70% of participants”
Quote in the paperNot a substantial claim
Findingcitation
In rural Gambian women, there was a clear preference for self-sampling using the cervical swab (97.1%) over self-sampling using tampon (84.4%) and clinician sampling using cervical brush (72.4%).
“there was a clear preference for self-sampling using the cervical swab (97.1%) over self-sampling using tampon (84.4%) and clinician sampling using cervical brush (72.4%).”
Quote in the paperNot a substantial claim
Findingcitation
When asked to compare self-sampling at home versus in a clinic, most end users expressed a preference to collect the sample at home.
“When asked to compare self-sampling at home versus in a clinic, most end users expressed a preference to collect the sample at home.32 33 44 58 66 68 74 91”
Quote in the paperSubstantial claim
Findingcitation
In two studies, end users reported a clear preference for clinic-based testing with a physician over self-sampling at home.
“In two studies, end users reported a clear preference for clinic-based testing with a physician over self-sampling at home.57 70”
Quote in the paperNot a substantial claim
Findingown data
Lack of self-confidence with collecting a reliable sample was the most commonly cited reason for preferring clinician-collected samples.
“Lack of self-confidence with collecting a reliable sample was the most commonly cited reason for preferring clinician-collected samples.”
Quote in the paperNot a substantial claim
Findingcitation
Other studies suggested strategies to increase end users' confidence in performing self-sampling correctly.
“Other studies suggested strategies to increase end user’s confidence in performing self-sampling correctly.47 55 70”
Quote in the paperNot a substantial claim
Findingown data
Of the 25 studies comparing age groups, 14 found no differences in preferences for self-sampling versus clinician sampling between older and younger women.
“Of these, 14 studies found no differences in preferences for self-sampling versus clinician sampling comparing older versus younger women.”
Quote in the paperNot a substantial claim
Findingcitation
Five studies reported greater preference for self-sampling among younger age groups compared with older age groups.
“Five studies reported greater preference for self-sampling among younger age groups compared with older age groups.”
Quote in the paperNot a substantial claim
Findingcitation
Only one study compared end users' preferences across different regions and countries.
“Only one study compared end users’ preferences across different regions and countries.”
Quote in the paperNot a substantial claim
Findingnone given
Studies presenting preferences or attitudes adjusted for sociodemographic and/or behavioural characteristics were more likely to find no difference in preference for self-sampling by age group.
“Studies presenting preferences or attitudes adjusted for sociodemographic and/or behavioural characteristics were more likely to find no difference in preference for self-sampling by age group.”
Quote in the paperNot a substantial claim
Findingcitation
Twenty-five studies compared differences in sampling preferences by age group.
“Twenty-five studies compared differences in sampling preferences by age group.”
Quote in the paperNot a substantial claim
Findingreasoning
Across studies, the home was regarded as a highly acceptable and convenient setting for self-sampling.
“Across studies, the home was regarded as a highly acceptable and convenient setting for self-sampling.”
Quote in the paperSubstantial claim
Findingcitation
Women who preferred clinician sampling expressed concerns about the reliability of self-sampled specimens.
“Women who preferred clinician sampling expressed concerns about the reliability of self-sampled specimens”
Quote in the paperNot a substantial claim
Findingown data
Only 15 studies examined alternative self-sampling devices and methods.
“however, only 15 studies examined these alternative self-sampling devices and methods.”
Quote in the paperSubstantial claim
Findingown data
Studies examining less commonly used devices and methods generally found high acceptability.
“Studies examining less commonly used devices (eg, tampon and labial padette) and methods (eg, urine sampling) generally found high acceptability”
Quote in the paperNot a substantial claim
Findingown data
Women generally preferred self-sampling over clinician sampling, citing ease of use, privacy, convenience and physical and emotional comfort as major reasons for their preference.
“Women generally preferred self-sampling over clinician sampling, citing ease of use, privacy, convenience and physical and emotional comfort as major reasons for their preference.”
Quote in the paperSubstantial claim
Findingnone given
Women expressed that they would prefer clinic-based sampling if home-based sampling meant they would not have access to a healthcare provider.
“However, women expressed that they would prefer clinic-based sampling if home-based sampling meant they would not have access to a healthcare provider.”
Quote in the paperSubstantial claim
Findingnone given
Among studies comparing acceptability of different self-sampling devices, end users preferred the cervical swab over other devices such as the lavage or cervical brush.
“Among studies comparing acceptability of different self-sampling devices, end users preferred the cervical swab over other devices such as the lavage or cervical brush”
Quote in the paperNot a substantial claim
Findingown data
End user concern that they would not get face time with a clinician if needed is a common reason for disliking self-sampling identified uniquely in this review.
“Another common reason identified uniquely in this review is end user concern that they would not get face time with a clinician if needed.”
Quote in the paperNot a substantial claim
Findingnone given
High levels of acceptability were consistent among vulnerable and underscreened subpopulations.
“Similarly, high levels of acceptability were consistent among vulnerable and underscreened subpopulations.”
Quote in the paperSubstantial claim
Findingnone given
The most common device for self-sampling was the cervical swab.
“The most common device for self-sampling was the cervical swab.”
Quote in the paperNot a substantial claim
Findingreasoning
More than half of home-based self-sampling studies took place in high-income countries.
“More than half of home-based self-sampling studies took place in high-income countries, since a quick and reliable postal system was necessary for mailing the samples for processing.”
Quote in the paperNot a substantial claim
Findingown data
In this systematic review, we found general consensus that self-sampling is a highly acceptable method for HPV testing, regardless of study location and sampling method, device, setting or participant demographics.
“In this systematic review, we found general consensus that self-sampling is a highly acceptable method for HPV testing, regardless of study location and sampling method, device, setting or participant demographics.”
Quote in the paperSubstantial claim
Premisecitation
End users' values and preferences regarding self-sampling method, device and setting have not been explored.
“Although previous reviews have found generally high acceptability of HPV DNA self-sampling, end users’ values and preferences regarding self-sampling method, device and setting have not been explored.13 15–17”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites 13 15–17
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Premisecitation
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”
Quote in the paperSubstantial claim0 of 3 sources checked
- cites [10] source
- cites [11] source
- cites [12] source
Premisecitation
HPV DNA self-sampling is generally a highly acceptable method for the purposes of cervical cancer screening.
“Generally, HPV DNA self-sampling is a highly acceptable method for the purposes of cervical cancer screening13”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites [13] source
Interpretationreasoning
HPV self-sampling is generally a highly accepted method of cervical cancer screening for end users globally.
“HPV self-sampling is generally a highly accepted method of cervical cancer screening for end users globally.”
Quote in the paperSubstantial claim
Premisecitation
In one study, Dutch young women cited decreased embarrassment, time/effort investment and a 'do-it-yourself' attitude more often than older women when describing why they preferred HPV self-sampling over clinician sampling.
“In one study, Dutch young women cited reasons of decreased embarrassment, time/effort investment and a ‘do-it-yourself’ attitude more often than older women when describing why they preferred HPV self-sampling over clinician sampling.”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites [33] Bosgraaf, 2014, Reasons for non-attendance to cervical screening and preferences for HPV self-sampling in Dutch women, Prev Med source

May combine two claims. 32
Classified as probably not a substantial claim. 28

May combine two claims.
Premisecitation
Among AGYW attending a teen health centre in the USA, acceptability for both self-sampling and clinician sampling was high.
“Among AGYW attending a teen health centre in the USA, acceptability for both self-sampling and clinician sampling was high.”
Quote in the paperNot a substantial claim1 of 1 sources checked
- cites [63] source
  Methods (Study Design; page unavailable) says participants were lesbian and bisexual women aged 21–26 recruited through an online LGBT panel, not attendees of a teen health centre. Results (HPV Self-Testing; page unavailable) reports 51% willing to use an HPV self-test at home, rather than high acceptability for both self- and clinician sampling; clinician-sampling acceptability was not measured. (LLM, conf=0.88)
  Checked by a reasoning model — may be wrong.
  Experimental — accuracy not yet measured
Probably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation
HPV DNA testing is recommended by WHO, the US Preventive Services Task Force and Australian, US and European national screening programme guidelines as an effective approach for the early detection of cervical cancer for women aged 30 years and older.
“HPV DNA testing is recommended by WHO, the US Preventive Services Task Force and Australian, US and European national screening programme guidelines as an effective approach for the early detection of cervical cancer for women ≥30 years.7–9”
Quote in the paperNot a substantial claim1 of 3 sources checked
- cites [7] World Health Organization . Guidelines for screening and treatment of precancerous lesions for cervical cancer prevention, 2013. Available: https://www.who.int/reproductivehealth/publications/cancers/screening_and_treatment_of_precancerous_lesions/en/
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [8] source
  Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
  Experimental — accuracy not yet measured
- cites [9] Moyer, 2012, Screening for cervical cancer: U.S. preventive services Task force recommendation statement, Ann Intern Med source
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitation
The systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
“We conducted this systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.21”
Quote in the paperNot a substantial claim1 of 1 sources checked
- cites [21] source
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitation
A coding matrix was modified from the Evidence Project risk of bias tool and the Critical Appraisal Skills Program checklist for qualitative studies to facilitate data extraction related to quality assessment.
“A coding matrix was modified from the Evidence Project risk of bias tool23 and the Critical Appraisal Skills Program checklist for qualitative studies to facilitate data extraction related to quality assessment.”
Quote in the paperNot a substantial claim1 of 1 sources checked
- cites [23] source
May combine two claims.
Premisecitation
A qualitative study of women in Switzerland found that younger women were used to visiting a gynaecologist and did not see the necessity of changing this practice.
“A qualitative study of women in Switzerland found that younger women were used to visiting a gynaecologist and did not see the necessity of changing this practice”
Quote in the paperNot a substantial claim1 of 1 sources checked
- cites [24] Fargnoli, 2015, To what extent will women accept HPV self-sampling for cervical cancer screening? A qualitative study conducted in Switzerland, Int J Womens Health source
May combine two claims.
Premisecitation
In that study, women in rural Uttar Pradesh (93.1%), Hyderabad (95.5%), Uganda (64.5%) and Nicaragua (50.0%) preferred self-sampling over clinician sampling.
“The study found that women in rural Uttar Pradesh (93.1%), Hyderabad (95.5%), Uganda (64.5%) and Nicaragua (50.0%) preferred self-sampling over clinician sampling.”
Quote in the paperNot a substantial claim1 of 1 sources checked
- cites [70] source
  Table 2 in Results > Ease and preference of self-sampling reports the four self-sampling percentages exactly as quoted. But in Nicaragua, 50.0% preferred self-collection and 50.0% preferred provider collection, so women there did not prefer self-sampling over clinician sampling. (LLM, conf=0.91)
  Experimental — accuracy not yet measured
May combine two claims.
Premisecitation
In that Swiss study, some older women, less used to regular gynaecological appointments, were more in favour of self-sampling, especially if they previously had had a negative experience with pelvic examinations.
“while some older women, less used to regular gynaecological appointments, were more in favour of self-sampling, especially if they previously had had a negative experience with pelvic examinations.”
Quote in the paperNot a substantial claim1 of 1 sources checked
- cites [24] Fargnoli, 2015, To what extent will women accept HPV self-sampling for cervical cancer screening? A qualitative study conducted in Switzerland, Int J Womens Health source
May combine two claims.
Premisecitation
In that study, more than half of surveyed respondents in each site reported self-sampling as 'easy', with the lowest percentage in Hyderabad (53.6%) and the highest in Uganda (89.7%).
“More than half of surveyed respondents in each site reported self-sampling as ‘easy’ with the lowest percentage in Hyderabad (53.6%) and the highest percentage in Uganda (89.7%).”
Quote in the paperNot a substantial claim1 of 1 sources checked
- cites [70] source
May combine two claims.
Premisecitation
Willingness to self-sample at home among lesbian and bisexual AGYW increased with age and concern about getting an HPV-related disease.
“Willingness increased with age and concern about getting an HPV-related disease.”
Quote in the paperNot a substantial claim1 of 1 sources checked
- cites [63] source
May combine two claims.
Premisecitation
Among HIV-positive women in South Africa, rural women preferred the cervical brush over other sampling devices, whereas urban women preferred the tampon over other devices.
“HIV-positive rural women preferred the cervical brush over other sampling devices, whereas urban women preferred the tampon over other devices.”
Quote in the paperNot a substantial claim1 of 1 sources checked
- cites [51] Mahomed, 2014, Human papillomavirus (HPV) testing on self-collected specimens: perceptions among HIV positive women attending rural and urban clinics in South Africa, Pan Afr Med J source
May combine two claims.
Interpretationcitation
HPV DNA self-sampling is a promising screening method that, when offered to women in low-resource settings, can address barriers that create inequalities in access to cervical cancer screening.
“HPV DNA self-sampling is a promising screening method that, when offered to women in low-resource settings, can address barriers that create inequalities in access to cervical cancer screening.”
Quote in the paperNot a substantial claim1 of 1 sources checked
- cites [97] Defo VF , JFJAjoe D . Why consider self-sampling for cervical cancer screening in Low-and middle-income countries? 2020;22:116–25. source
May combine two claims.
Interpretationcitation
Screening with high uptake will expedite reductions and will be necessary to eliminate cervical cancer in countries with the highest burden.
“Screening with high uptake will expedite reductions and will be necessary to eliminate cervical cancer in countries with the highest burden.”
Quote in the paperSubstantial claim1 of 1 sources checked
- cites [98] Brisson, 2020, Impact of HPV vaccination and cervical screening on cervical cancer elimination: a comparative modelling analysis in 78 low-income and lower-middle-income countries, The Lancet source
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingown data
The 72 included studies included a total of 52,114 participants.
“The 72 studies included a total of 52 114 participants”
Quote in the paperNot a substantial claim
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingown data
Of the included participants, 57% were from high-income countries.
“Of the included participants, 57% were from high-income countries.”
Quote in the paperNot a substantial claim
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown data
Studies were conducted in a variety of countries, including all WHO regions and all World Bank country income classification categories.
“Studies were conducted in a variety of countries, including all WHO regions and all World Bank country income classification categories (high, middle and low income).”
Quote in the paperNot a substantial claim
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingnone given
Participants ranged in age from 14 to 80 years.
“Participants ranged in age from 14 to 80 years.”
Quote in the paperNot a substantial claim
May combine two claims.
Findingown data
Common issues with study quality were sampling/selection bias, lack of validation of survey measures and lack of transferability of values and preferences results.
“Common issues with study quality were sampling/selection bias, lack of validation of survey measures and lack of transferability of values and preferences results.”
Quote in the paperNot a substantial claim
May combine two claims.
Findingown data
Other study quality concerns identified included no consideration of study limitations, preference bias due to patient-physician interaction, recall bias, social desirability bias, low response rate and high loss to follow-up.
“Other study quality concerns identified in this review included: no consideration of study limitations, preference bias due to patient–physician interaction, recall bias, social desirability bias, low response rate and high loss to follow-up.”
Quote in the paperNot a substantial claim
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingown data
Study populations typically included adult end users.
“Study populations typically included adult end users.”
Quote in the paperNot a substantial claim
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingcitation
Five studies employed a multimethod or mixed methods design.
“Five studies employed a multimethod or mixed methods design.47 67–70”
Quote in the paperNot a substantial claim
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingown data
Six qualitative studies asked about hypothetical acceptability of HPV self-sampling.
“Six qualitative studies asked about hypothetical acceptability of HPV self-sampling.”
Quote in the paperNot a substantial claim
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown data
Articles were published between 2002 and 2018, with 50% published since 2015.
“Articles were published between 2002 and 2018, with 50% published since 2015.”
Quote in the paperNot a substantial claim
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingown data
Sample sizes for individual included studies ranged from 17 to 9484.
“sample sizes for individual studies ranged from 17 to 9484”
Quote in the paperNot a substantial claim
May combine two claims.
Findingown data
One study assessed test-retest reliability and content validity of acceptability measures, but psychometric properties of acceptability were not conducted consistently across studies.
“One study assessed test–retest reliability and content validity of acceptability measures,64 but psychometric properties of acceptability were not conducted consistently across studies.”
Quote in the paperNot a substantial claim
May combine two claims.
Findingcitation
End users generally found HPV self-sampling acceptable and/or expressed willingness to undergo future HPV testing using self-sampling.
“End users generally found HPV self-sampling acceptable and/or expressed willingness to undergo future HPV testing using self-sampling.24 26 27 30 32 34 36–39 41 42 44 46 47 50 53 54 56 58 60–63 66–69 71 73 74 79–85 87–93 95”
Quote in the paperSubstantial claim
May combine two claims.
Findingown data
A total of 58 studies employed a quantitative approach: 47 cross-sectional studies, two pre-post surveys, eight RCTs and one prospective cohort.
“A total of 58 studies employed a quantitative approach: 47 cross-sectional studies,41–46 48 50–63 65 66 71–94 two pre–post surveys,64 95 eight RCTs33–40 and one prospective cohort.49”
Quote in the paperNot a substantial claim
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown data
Almost all included studies were cross-sectional surveys, though some study designs included in-depth interviews and/or focus group discussions.
“Almost all studies were cross-sectional surveys, though some study designs included in-depth interviews and/or focus group discussions.24–32”
Quote in the paperNot a substantial claim
May combine two claims.
Findingown data
Most (n=67) quantitative studies focused on end users in high-income countries, while only 15 quantitative studies were conducted in low-income or lower middle-income countries.
“Most (n=67) quantitative studies focused on end users in high-income countries, while only 15 quantitative studies were conducted in low-income or lower middle-income countries.”
Quote in the paperNot a substantial claim
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingcitation
Two qualitative studies examined cervicovaginal self-sampling device preferences, two examined urine self-sampling and one examined self-sampling with a labial padette.
“Two qualitative studies examined cervicovaginal self-sampling device preferences,26 28 two examined urine self-sampling30 66 and one examined self-sampling with a labial padette.29”
Quote in the paperNot a substantial claim
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingown data
Of the nine qualitative studies, seven were conducted in high-income countries in Europe and North America.
“Of the nine qualitative studies, seven were conducted in high-income countries in Europe and North America24–29 31”
Quote in the paperNot a substantial claim
May combine two claims.
Findingcitation
Reasons for preferring clinic-based testing were lack of confidence in ability to self-sample and ability to receive treatment if needed.
“Reasons for preferring clinic-based testing were lack of confidence in ability to self-sample57 and ability to receive treatment if needed.70”
Quote in the paperNot a substantial claim
May combine two claims.
Findingnone given
Preferences related to self-sampling including sampling device, method and setting varied by region, subpopulation and age, though most end users found the process of self-sampling acceptable overall.
“Preferences related to self-sampling including sampling device (eg, swab, brush and tampon), method (eg, cervicovaginal and urine), setting (eg, home, clinic and community-based site) varied by region, subpopulation and age, though most end users found the process of self-sampling acceptable overall.”
Quote in the paperSubstantial claim
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingcitation
Clear, step-by-step instructions with illustrations in the appropriate language were suggested as methods to facilitate self-sampling and improve end users' confidence.
“In addition, clear, step-by-step instructions with illustrations in the appropriate language were suggested as methods to facilitate self-sampling and improve end users’ confidence.62 68 79 81”
Quote in the paperNot a substantial claim
May combine two claims.
Findingnone given
Self-sampled specimens are seen as acceptable in terms of ease of use, convenience, privacy, and physical and emotional comfort, including decreased embarrassment, anxiety, and pain.
“Self-sampled specimens are seen as acceptable in terms of ease of use, convenience, privacy, and physical and emotional comfort (including decreased embarrassment, anxiety, and pain).”
Quote in the paperSubstantial claim
May combine two claims.
Findingnone given
In high-income countries, samples collected at home were usually sent for processing using the postal service, whereas in some low-income and middle-income countries, self-sampled specimens were collected by community health workers conducting home visits for processing from the homes of participants rather than mail.
“In high-income countries, samples collected at home were usually sent for processing using the postal service, whereas in some low-income and middle-income countries, self-sampled specimens were collected by community health workers conducting home visits for processing from the homes of participants rather than mail.”
Quote in the paperNot a substantial claim
May combine two claims.
Findingnone given
The cervical swab was by far the most common and well accepted HPV DNA sampling device.
“The cervical swab was by far the most common and well accepted.”
Quote in the paperNot a substantial claim
May combine two claims.
Findingcitation
Most women experiencing homelessness found the labial padette to be an acceptable form of self-sampling and preferred it over clinician sampling using a cervical brush, though some were concerned about reliability of the self-sampled specimens.
“Most women found the labial padette to be an acceptable form of self-sampling and was preferred over clinician sampling using a cervical brush though some women were concerned about reliability of the self-sampled specimens.29”
Quote in the paperNot a substantial claim
May combine two claims.
Findingcitation
Several studies assessed women's preferences for different self-sampling devices and acceptability was generally high for all devices.
“Several studies assessed women’s preferences for different self-sampling devices and acceptability was generally high for all devices.26 28 32–34 49–51 54 67 80 89”
Quote in the paperNot a substantial claim
May combine two claims.
Findingcitation
In a sample of HIV-positive South African women, the highest preference was for the cervical brush (51%), while fewer women preferred the tampon (31%) or lavage sampler (18%).
“a sample of HIV-positive South African women rated the highest preference for the cervical brush (51%), while fewer women preferred the tampon (31%) or lavage sampler (18%).51”
Quote in the paperNot a substantial claim
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingcitation
Other devices tested included the lavage, cervical brush, tampon and labial padette.
“Other devices tested included the lavage,74 81 85 cervical brush,42–44 48 52 53 55 60 69 70 72 79 82 84 86–88 92 94 95 tampon32 34 49–51 and labial padette.29”
Quote in the paperNot a substantial claim
May combine two claims.
Findingown data
Only 3 of the 72 studies included in this review were conducted in low-income countries, leaving a critical gap in understanding of end users' preferences in these settings.
“Only 3 of the 72 studies included in this review were conducted in low-income countries, leaving a critical gap in understanding of end users’ preferences in these settings.”
Quote in the paperSubstantial claim
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingnone given
In some low-income and middle-income countries, community health workers collected specimens self-sampled by participants for processing during home-visits.
“In some low-income and middle-income countries, community health workers collected specimens self-sampled by participants for processing during home-visits.”
Quote in the paperNot a substantial claim
Probably not a substantial claim: may not pass S4 (based).
Findingnone given
HPV self-sampling is generally a highly accepted method of cervical cancer screening for women across the world.
“HPV self-sampling is generally a highly accepted method of cervical cancer screening for women across the world.”
Quote in the paperNot a substantial claim
Classified as probably not a substantial claim.
Premisecitation
Typically, per current recommendations, cervicovaginal samples for HPV DNA testing are collected by a clinician during a pelvic examination.
“Typically, per current recommendations, cervicovaginal samples for HPV DNA testing are collected by a clinician during a pelvic examination.8 9”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites 8 9
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation
In areas with high endemic HIV, WHO recommends that sexually active girls and women, regardless of age, should be screened as soon as they have tested positive for HIV.
“In addition, in areas with high endemic HIV, WHO recommends that sexually active girls and women, regardless of age, should be screened as soon as they have tested positive for HIV.7”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites [7] World Health Organization . Guidelines for screening and treatment of precancerous lesions for cervical cancer prevention, 2013. Available: https://www.who.int/reproductivehealth/publications/cancers/screening_and_treatment_of_precancerous_lesions/en/
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation
Previous reviews have found generally high acceptability of HPV DNA self-sampling.
“Although previous reviews have found generally high acceptability of HPV DNA self-sampling, end users’ values and preferences regarding self-sampling method, device and setting have not been explored.13 15–17”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites 13 15–17
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductnone given
Two reviewers independently assessed all full-text articles for study inclusion eligibility and resolved differences through consensus.
“Two reviewers independently assessed all full-text articles for study inclusion eligibility and resolved differences through consensus.”
Quote in the paperNot a substantial claim
Classified as probably not a substantial claim.
Interpretationreasoning
End user preferences for self-sampling device, method and setting can inform the development of new and expanded interventions to increase HPV screening.
“End user preferences for self-sampling device, method and setting can inform the development of new and expanded interventions to increase HPV screening.”
Quote in the paperSubstantial claim
- Rests on an assumption: HPV testing must be acceptable to end users, in particular those who are underscreened and most vulnerable to cervical cancer, for screening programmes to succeed.
Probably not a substantial claim: may not pass S2 (checkable), S4 (based).
Interpretationreasoning
Understanding end users' preferences for self-sampling is critical for reaching the WHO global target of 70% HPV screening coverage by 2030.
“Understanding end users’ preferences for self-sampling is critical for reaching the WHO global target of 70% HPV screening coverage by 2030.”
Quote in the paperNot a substantial claim
- Rests on an assumption: HPV testing must be acceptable to end users, in particular those who are underscreened and most vulnerable to cervical cancer, for screening programmes to succeed.
Classified as probably not a substantial claim. May combine two claims.
Study design and conductnone given
Two reviewers independently used a standardised data abstraction form to capture information on location of study, study population, sample size and results related to values and preferences from each study, and differences in data abstraction were resolved through consensus, with a third reviewer as needed.
“Two reviewers independently used a standardised data abstraction form to capture information on location of study, study population, sample size and results related to values and preferences from each study. Differences in data abstraction were resolved through consensus, with a third reviewer as needed.”
Quote in the paperSubstantial claim
Probably not a substantial claim: may not pass S3 (load-bearing).
Interpretationreasoning
The preference for cervical swab could be due to greater familiarity with cervical swab.
“but this preference could be due to greater familiarity with cervical swab.”
Quote in the paperNot a substantial claim
May combine two claims.
Study design and conductreasoning
We did not include conference abstracts or grey literature in this review, so our findings may not fully represent the full body of literature on values and preferences for HPV self-sampling.
“We did not include conference abstracts or grey literature in this review, so our findings may not fully represent of the full body of literature on values and preferences for HPV self-sampling.”
Quote in the paperNot a substantial claim
Classified as probably not a substantial claim. May combine two claims.
Study design and conductreasoning
Given the diversity of measures used to assess values and preferences, it is difficult to make comparisons across studies and therefore difficult to determine the specific aspects of self-sampling that clients find acceptable and whether these hold true for clients in different age groups, geographic regions and socioeconomic status.
“Given the diversity of measures used to assess values and preferences, it is difficult to make comparisons across studies and therefore difficult to determine the specific aspects of self-sampling that clients find acceptable and whether these hold true for clients in different age groups, geographic regions and socioeconomic status.”
Quote in the paperSubstantial claim

53 of 53

The paper relies on this without support.
WHO recommends HPV cervical self-sampling as an additional screening method.
“The WHO recommends human papillomavirus (HPV) cervical self-sampling as an additional screening method”
The paper relies on this without support.
HPV testing must be acceptable to end users, in particular those who are underscreened and most vulnerable to cervical cancer, for screening programmes to succeed.
“Understanding end users’ values and preferences related to self-sampling is critical because HPV testing must be acceptable to end users, in particular those who are underscreened and most vulnerable to cervical cancer.”
The paper relies on this without support.
Understanding women’s preferences for HPV self-sampling is a critical factor for expanding choice, coverage and uptake of cervical cancer screening.
“Understanding women’s preferences for HPV self-sampling is a critical factor for expanding choice, coverage and uptake of cervical cancer screening.”

3 of 3

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

Reported minimum study size excludes a 15-person study
Minor
The stated minimum sample size is 17, but Table 2 lists Katz's study with a sample size of 15.
Eligibility requires performed self-sampling, but hypothetical-use studies are included
Minor
The inclusion criteria require participants who performed self-sampling, yet Table 2 includes studies classified as hypothetical rather than actual use.
High-income quantitative study count exceeds all quantitative studies
Minor
The paper says 67 quantitative studies focused on high-income countries, but reports only 58 quantitative studies in total.
A cited home self-sampling study is listed as clinic-based
Minor
Study 49 is cited among studies in which users self-sampled at home, but Table 2 gives its setting as clinic.
A quantitative urine study is called qualitative
Minor
The text includes study 66 among two qualitative studies examining urine self-sampling, while Table 2 classifies study 66 as quantitative.

5 of 5

Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823 · see citing works
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & The PRISMA Group (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000097 · Cited by 64,042 · cited 1× · see citing works
“21”
Global cancer statistics
Jemal, A., Bray, F., Ferlay, J., Ward, E., & Forman, D. (2011) · CA A Cancer Journal for Clinicians · doi:10.3322/caac.20107 · Cited by 54,708 · see citing works
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement.
(2009) · PubMed Central · Cited by 44,859 · see citing works
The Effect of Riding as an Alternative Treatment for Children with Cerebral Palsy: A Systematic Review and Meta-Analysis
Wang, G., Ma, R., Qiao, G., Wada, K., Aizawa, Y., & Satoh, T. (2015) · Integrative Medicine International · doi:10.1159/000368408 · Cited by 18,759 · see citing works
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz
(2013) · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz · doi:10.1007/103.1437-1588 · Cited by 11,769 · see citing works
Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis
Arbyn, M., Weiderpass, E., Bruni, L., de Sanjosé, S., Saraiya, M., Ferlay, J., & Bray, F. (2019) · The Lancet Global Health · doi:10.1016/s2214-109x(19)30482-6 · Cited by 4,241 · see citing works
Users' guides to the medical literature : a manual for evidence-based clinical practice
Guyatt, G. H., Rennie, D., Meade, M. O., & Cook, D. J. (2002) · Cited by 1,196 · see citing works
Screening for cervical cancer: U.S. preventive services Task force recommendation statement
Moyer, V. A., & on behalf of the U.S. Preventive Services Task Force* (2012) · Annals of Internal Medicine · doi:10.7326/0003-4819-156-12-201206190-00424 · Cited by 1,049 · see citing works
Impact of HPV vaccination and cervical screening on cervical cancer elimination: a comparative modelling analysis in 78 low-income and lower-middle-income countries
Brisson, M., Kim, J. J., Canfell, K., Drolet, M., Gingras, G., Burger, E. A., Martin, D., Simms, K. T., Bénard, É., Boily, M.-C., et al. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30068-4 · Cited by 943 · see citing works
Accuracy of human papillomavirus testing on self-collected versus clinician-collected samples: a meta-analysis
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., et al. (2014) · The Lancet Oncology · doi:10.1016/s1470-2045(13)70570-9 · Cited by 674 · see citing works
Mortality impact of achieving WHO cervical cancer elimination targets: a comparative modelling analysis in 78 low-income and lower-middle-income countries
Canfell, K., Kim, J. J., Brisson, M., Keane, A., Simms, K. T., Caruana, M., Burger, E. A., Martin, D., Nguyen, D. T. N., Bénard, É., et al. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30157-4 · Cited by 650 · see citing works
Self-sampling for human papillomavirus (HPV) testing: a systematic review and meta-analysis
Yeh, P. T., Kennedy, C. E., Vuyst, H. D., & Narasimhan, M. (2019) · BMJ Global Health · doi:10.1136/bmjgh-2018-001351 · Cited by 328 · cited 1× · see citing works
“The full search strategy is described in a complementary review of the effectiveness of HPV self-sampling compared with clinician sampling 22 ; the same search strategy was used for both the effectiveness review and this values and preferences review.”
MethodSelf-citation
Are self-collected samples comparable to physician-collected cervical specimens for human papillomavirus DNA testing? A systematic review and meta-analysis
Petignat, P., Faltin, D. L., Bruchim, I., Tramèr, M. R., Franco, E. L., & Coutlée, F. (2007) · Gynecologic Oncology · doi:10.1016/j.ygyno.2007.01.023 · Cited by 290 · see citing works
High‐risk HPV testing on self‐sampled <i>versus</i> clinician‐collected specimens: A review on the clinical accuracy and impact on population attendance in cervical cancer screening
Snijders, P. J. F., Verhoef, V. M. J., Arbyn, M., Ogilvie, G., Minozzi, S., Banzi, R., van Kemenade, F. J., Heideman, D. A. M., & Meijer, C. J. L. M. (2013) · International Journal of Cancer · doi:10.1002/ijc.27790 · Cited by 265 · see citing works
European guidelines for quality assurance in cervical cancer screening. Summary of the supplements on HPV screening and vaccination
von Karsa, L., Arbyn, M., De Vuyst, H., Dillner, J., Dillner, L., Franceschi, S., Patnick, J., Ronco, G., Segnan, N., Suonio, E., et al. (2015) · Papillomavirus Research · doi:10.1016/j.pvr.2015.06.006 · Cited by 253 · see citing works
The acceptability of self-sampled screening for HPV DNA: a systematic review and meta-analysis
Nelson, E. J., Maynard, B. R., Loux, T., Fatla, J., Gordon, R., & Arnold, L. D. (2017) · Sexually Transmitted Infections · doi:10.1136/sextrans-2016-052609 · Cited by 252 · see citing works
Status of HPV vaccine introduction and barriers to country uptake
Gallagher, K. E., LaMontagne, D. S., & Watson‐Jones, D. (2018) · Vaccine · doi:10.1016/j.vaccine.2018.02.003 · Cited by 247 · see citing works
Self-collected HPV Testing Improves Participation in Cervical Cancer Screening: A Systematic Review and Meta-analysis
Racey, C. S., Withrow, D. R., & Gesink, D. (2013) · Canadian Journal of Public Health · doi:10.1007/bf03405681 · Cited by 232 · see citing works
The Evidence Project risk of bias tool: assessing study rigor for both randomized and non-randomized intervention studies
Kennedy, C. E., Fonner, V. A., Armstrong, K. A., Denison, J. A., Yeh, P. T., O’Reilly, K. R., & Sweat, M. D. (2019) · Systematic Reviews · doi:10.1186/s13643-018-0925-0 · Cited by 212 · see citing works
Self-citation
The Acceptability of Self-Collected Samples for HPV Testing vs. the Pap Test as Alternatives in Cervical Cancer Screening
Dzuba, I. G., Díaz, E. Y., Allen, B., Leonard, Y. F., Lazcano Ponce, E. C., Shah, K. V., Bishai, D., Lorincz, A., Ferris, D., Turnbull, B., et al. (2002) · Journal of Women's Health & Gender-Based Medicine · doi:10.1089/152460902753668466 · Cited by 208 · see citing works
Acceptability of self-collection sampling for HPV-DNA testing in low-resource settings: a mixed methods approach
Bansil, P., Wittet, S., Lim, J. L., Winkler, J. L., Paul, P., & Jeronimo, J. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-596 · Cited by 184 · see citing works
Self-Sampling for Human Papillomavirus Testing: Increased Cervical Cancer Screening Participation and Incorporation in International Screening Programs
Gupta, S., Palmer, C., Bik, E. M., Cárdenas, J. P., Núñez, H., Kraal, L., Bird, S. W., Bowers, J., Smith, A. J., Walton, N. A., et al. (2018) · Frontiers in Public Health · doi:10.3389/fpubh.2018.00077 · Cited by 157 · see citing works
Test performance and acceptability of self- versus provider-collected swabs for high-risk HPV DNA testing in female-to-male trans masculine patients.
Reisner, S. L., Deutsch, M. B., Peitzmeier, S. M., White Hughto, J. M., Cavanaugh, T. P., Pardee, D. J., McLean, S. A., Panther, L. A., Gelman, M., Mimiaga, M. J., et al. (2018) · PLoS ONE · doi:10.1371/journal.pone.0190172 · Cited by 126 · see citing works
Emerging role of HPV self-sampling in cervical cancer screening for hard-to-reach women: Focused literature review.
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Cervico-Vaginal self-collection in HIV-infected and uninfected women from Tapajós region, Amazon, Brazil: high acceptability, hrHPV diversity and risk factors
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Women in the Netherlands Prefer Self-Sampling With a Novel Lavaging Device to Clinician Collection of Specimens for Cervical Cancer Screening
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Effect of Educational Intervention on Self-Sampling Acceptability and Follow-Up Paps in Border Dwelling Hispanic Females
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Worldwide use of HPV self-sampling for cervical cancer screening
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“A DoS detection system based on a machine learning method for DAR-ML (Dynamic Secure Aware Routing by Machine Learning) would aid in the resolution of healthcare data (Nishimura et al., 2021).”
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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
Costa, S., Verberckmoes, B., Castle, P. E., & Arbyn, M. (2023) · British Journal of Cancer · doi:10.1038/s41416-022-02094-w · Cited by 139 · see citing works
“The offer at a healthcare service, also seems to be a promising strategy to improve screening participation rates since similarly to the community mobilisation & outreach scenario, it benefits from the face-to-face invitation, also giving women the chance to clarify any doubts that might exist with regards to the inst…”
Background
Human Papillomavirus Epidemiology and Prevention: Is There Still a Gender Gap?
Milano, G., Guarducci, G., Nante, N., et al. (2023) · Vaccines · doi:10.3390/vaccines11061060 · Cited by 76 · see citing works
Cervical cancer burden, status of implementation and challenges of cervical cancer screening in Association of Southeast Asian Nations (ASEAN) countries
Zhao, S., Huang, L., Basu, P. S., Domingo, E. J., Supakarapongkul, W., Ling, W. Y., Ocviyanti, D., Rezhake, R., Qiao, Y., Tay, E. H., et al. (2021) · Cancer Letters · doi:10.1016/j.canlet.2021.10.036 · Cited by 75 · see citing works
Epidemiology, Molecular Pathogenesis, Immuno-Pathogenesis, Immune Escape Mechanisms and Vaccine Evaluation for HPV-Associated Carcinogenesis
Jain, M., Yadav, D., Jarouliya, U., Chavda, V. K., Yadav, A. K., Chaurasia, B. K., & Song, M. (2023) · Pathogens · doi:10.3390/pathogens12121380 · Cited by 68 · see citing works
“Comprehensive surveillance programs at national or subnational levels targeting these three pillars (screening, vaccination, and treatment) are a framework in the WHO Global Strategy to reduce cervical cancer for public health concerns [157].”
Background
Does self-sampling for human papilloma virus testing have the potential to increase cervical cancer screening? An updated meta-analysis of observational studies and randomized clinical trials
Gennaro, G. D., Licata, F., Trovato, A., & Bianco, A. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.1003461 · Cited by 69 · see citing works
Real-world impact and effectiveness of the quadrivalent HPV vaccine: an updated systematic literature review
Wang, W., Kothari, S., Skufca, J., et al. (2022) · Expert Review of Vaccines · doi:10.1080/14760584.2022.2129615 · Cited by 59 · see citing works
HPV and Cervical Cancer—Biology, Prevention, and Treatment Updates
Włoszek, E., Krupa, K., Skrok, E., Budzik, M. P., Deptała, A., & Badowska-Kozakiewicz, A. M. (2025) · Current Oncology · doi:10.3390/curroncol32030122 · Cited by 59 · see citing works
“Even so, some women prefer clinician-collected samples because they are concerned about their ability to collect a reliable sample on their own [101].”
Advances and Challenges in Cervical Cancer: From Molecular Mechanisms and Global Epidemiology to Innovative Therapies and Prevention Strategies
Hakim, R. U., Amin, T., & Islam, S. M. B. U. (2025) · Cancer Control · doi:10.1177/10732748251336415 · Cited by 38 · see citing works
“The immature cervix, especially the transformation zone where columnar epithelial cells are exposed during adolescence, is more susceptible to HPV. 46 Furthermore, improved compliance with contraceptives has not occurred and as such younger women are likely to lapse on contraceptives, thus…”
Looking Back, Moving Forward: Challenges and Opportunities for Global Cervical Cancer Prevention and Control
Castle, P. E. (2024) · Viruses · doi:10.3390/v16091357 · Cited by 38 · see citing works
“However, one of the primary barriers to the acceptance of self-collection is a lack of self-efficacy (i.e., women are concerned as to whether they can complete it “as well as the clinicians”), and women cite this as a reason that they might prefer provider-collected cervical specimens [130–132].”
Background
Prevalence and Genotype Distribution of Human Papillomavirus Infection among 12 076 Iranian Women
Bitarafan, F., Hekmat, M. R., Khodaeian, M., Razmara, E., Ashrafganjoei, T., Gilani, M. M., Mohit, M., Aminimoghaddam, S., Cheraghi, F., Khalesi, R., et al. (2021) · International Journal of Infectious Diseases · doi:10.1016/j.ijid.2021.07.071 · Cited by 33 · see citing works
Detection of endometrial cancer using tampon-based collection and methylated DNA markers
Bakkum-Gamez, J. N., Sherman, M. E., Slettedahl, S. W., Mahoney, D. W., Lemens, M. A., Laughlin-Tommaso, S. K., Hopkins, M. R., VanOosten, A. L., Shridhar, V., Staub, J. K., et al. (2023) · Gynecologic Oncology · doi:10.1016/j.ygyno.2023.04.014 · Cited by 30 · see citing works
Accuracy of HPV testing on self-collected and clinician-collected samples for different screening strategies in African settings: A systematic review and meta-analysis
Sy, F., Greuel, M., Winkler, V. F., Bussmann, H., Bärnighausen, T., & Deckert, A. (2022) · Gynecologic Oncology · doi:10.1016/j.ygyno.2022.06.012 · Cited by 30 · see citing works
Comparison of diagnostic accuracy and acceptability of self-sampling devices for human Papillomavirus detection: A systematic review
Aimagambetova, G. N., Atageldiyeva, K. K., Marat, А., et al. (2024) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2024.102590 · Cited by 29 · see citing works
“…studies assessing the acceptability of HPV self-sampling devices and strongly support “ inclusion of self-sampling for HPV testing ” as an additional approach for cervical cancer screening programs where HPV DNA testing is used (Verdoodt et al., 2015; Morgan et al., 2019; Nishimura et al., 2021).”
BackgroundInfluential
Revolutionizing HPV Detection: Unveiling a Novel Electrochemical Immunosensor for Ultra-Sensitive HPV16 E7 Oncoprotein Detection Based on Gold-Graphitic Carbon Nitride Nanocomposite
Kotal, H., Kalyani, T., Sangili, A., et al. (2024) · Journal of The Electrochemical Society · doi:10.1149/1945-7111/ad281b · Cited by 26 · see citing works
Testing positive for Human Papillomavirus (HPV) at primary HPV cervical screening: A qualitative exploration of women’s information needs and preferences for communication of results
Symmons, S. M., Waller, J., & McBride, E. (2021) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2021.101529 · Cited by 25 · see citing works
“HPV self-sampling has been introduced recently in some countries targeted at women who have not attended routine screening and has been found to be acceptable to women regardless of demographic characteristics (Nishimura et al., 2021).”
BackgroundMethod
Cervical Cancer Prevention and High-Risk HPV Self-Sampling Awareness and Acceptability among Women Living with HIV: A Qualitative Investigation from the Patients’ and Providers’ Perspectives
Le, D., Ciceron, A. C., Jeon, M. J., Gonzalez, L. I., Jordan, J. A., Bordón, J., & Long, B. J. (2022) · Current Oncology · doi:10.3390/curroncol29020047 · Cited by 26 · see citing works
Exploring Factors Associated with Patients Who Prefer Clinician-Sampling to HPV Self-Sampling: A Study Conducted in a Low-Resource Setting
Sormani, J., Kenfack, B., Wisniak, A., Datchoua, A. M., Makajio, S. L., Schmidt, N. C., Vassilakos, P., & Petignat, P. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19010054 · Cited by 23 · see citing works
“This approach reduces the discomfort and pain that can be associated with pelvic examination, is considered less invasive, allows women more autonomy and privacy, and might facilitate screening participation [8,13,14].”
Background
Clinical indications for host-cell DNA methylation markers in cervical screening and management of cervical intraepithelial neoplasia: A review
Dick, S., Heideman, D. A. M., Berkhof, J. H., Steenbergen, R. D. M., & Bleeker, M. C. G. (2024) · Tumour Virus Research · doi:10.1016/j.tvr.2024.200308 · Cited by 24 · see citing works
Comparison of self-collected versus clinician collected cervicovaginal specimens for detection of high risk human papillomavirus among HIV infected women in Ethiopia
Bogale, A. L., Teklehaymanot, T., Haidar, J., Kassie, G. M., Medhin, G., Yizengaw, A., & Yilma, A. (2022) · BMC Women s Health · doi:10.1186/s12905-022-01944-2 · Cited by 22 · see citing works
“Studies indicated that HPV self-sampling was the potential to increase the coverage of cervical cancer screening [40] and highly accepted cervical cancer screening method for end users [41, 42], that complements recent screening program by increasing population coverage [33].”
Background
Experiences of Self‐Sampling and Future Screening Preferences in Non‐Attenders Who Returned an HPV Vaginal Self‐Sample in the YouScreen Study: Findings From a Cross‐Sectional Questionnaire
Drysdale, H., Marlow, L. A. V., Lim, A. W., & Waller, J. (2024) · Health Expectations · doi:10.1111/hex.14118 · Cited by 21 · see citing works
“Clear step ‐ by ‐ step instructions and the opportunity to ask healthcare professionals questions, can help reassure women that they are collecting a sample correctly [13].”
Background
Acceptability of self-sampling and self-testing for infections: a rapid systematic review on public users’ views
Borek, A., Roleston, C., Lazzarino, R., Cooray, M., Hayward, G., Roberts, N. W., Blandford, E., Fowler, T., & Tonkin-Crine, S. K. (2025) · BMC Public Health · doi:10.1186/s12889-025-21773-w · Cited by 18 · see citing works
Human papillomavirus self-sampling for long-term non-attenders in cervical cancer screening: A randomised feasibility study in Estonia
Veerus, P., Hallik, R., Jänes, J., Jõers, K., Paapsi, K., Laidra, K., & Innos, K. (2021) · Journal of Medical Screening · doi:10.1177/09691413211052499 · Cited by 19 · see citing works
Women's critical experiences with the pap smear for the development of cervical cancer screening devices
Arrivillaga, M., Bermúdez, P. C., García-Cifuentes, J. P., Rodríguez‐López, M., Neira, D., & Cardona, H. D. V. (2023) · Heliyon · doi:10.1016/j.heliyon.2023.e14289 · Cited by 24 · see citing works
HPV self-sampling among cervical cancer screening users in Spain: A randomized clinical trial of on-site training to increase the acceptability
Ibáñez, R., Roura, E., Acera, A., Andújar, M., Pavón, M. Á., Bruni, L., & de Sanjosé, S. (2023) · Preventive Medicine · doi:10.1016/j.ypmed.2023.107571 · Cited by 19 · see citing works
Trends and Determinants in Uptake of Cervical Cancer Screening in Spain: An Analysis of National Surveys from 2017 and 2020
de la Cruz, S. P., & Cebrino, J. (2022) · Cancers · doi:10.3390/cancers14102481 · Cited by 17 · see citing works
“Here, there is evidence that HPV self-sampling has the potential to increase access to and adoption of screening globally [36], and in fact, self-sampling is now being tested in Spain [37].”
Background
Partial progress in sexual and reproductive health and rights: the influence of sociocultural, behavioural, structural, and technological changes on epidemiological trends
Grulich, A. E., Mercer, C. H., Sturrock, B. R., Baral, S., Turpin, N., Phanuphak, N., Rowley, J. T., Wi, T., Gemzell‐Danielsson, K., Garcia‐Moreno, C., et al. (2025) · The Lancet · doi:10.1016/s0140-6736(25)01188-2 · Cited by 18 · see citing works
Understanding the Challenges of HPV-Based Cervical Screening: Development and Validation of HPV Testing and Self-Sampling Attitudes and Beliefs Scales
Tatar, O., Haward, B., Zhu, P., Griffin-Mathieu, G., Perez, S., McBride, E., Lofters, A., Smith, L., Mayrand, M., Daley, E. M., et al. (2023) · Current Oncology · doi:10.3390/curroncol30010093 · Cited by 16 · see citing works
“The Concerns factor included an item pertaining to confidence in using a self-sampling kit and the potential for harm with self-sampling, which were both commonly reported components of self-sampling acceptability identified in systematic reviews [19,20].”
Background
Exploring Factors Influencing Cervical Cancer Screening Participation among Singaporean Women: A Social Ecological Approach
Huang, Q., & Tan, L.-Y. (2024) · Cancers · doi:10.3390/cancers16203475 · Cited by 16 · see citing works
“Such initiatives could also potentially facilitate early detection, enhance treatment outcomes, and ultimately reduce the overall cervical cancer burden within the population.”
Background
Canadian Guideline on the Management of a Positive Human Papillomavirus Test and Guidance for Specific Populations
Zigras, T., Mayrand, M., Bouchard, C., Salvador, S., Eiriksson, L. R., Almadin, C., Kean, S., Dean, E. A., Malhotra, U., Todd, N. J., et al. (2023) · Current Oncology · doi:10.3390/curroncol30060425 · Cited by 15 · see citing works
“Regardless, the authors reported that high levels of acceptability were consistent among vulnerable and under-screened populations in the review [39].”
Background
Diagnostic accuracy of menstrual blood for human papillomavirus detection in cervical cancer screening: a systematic review
Chakravarti, P., Maheshwari, A., Tahlan, S., Kadam, P. R., Bagal, S. S., Gore, S., Panse, N. S., Deodhar, K., Chaturvedi, P., Dikshit, R. P., et al. (2022) · ecancermedicalscience · doi:10.3332/ecancer.2022.1427 · Cited by 14 · see citing works
AI-assisted system improves the work efficiency of cytologists via excluding cytology-negative slides and accelerating the slide interpretation
Du, H., Dai, W., Zhou, Q., et al. (2023) · Frontiers in Oncology · doi:10.3389/fonc.2023.1290112 · Cited by 14 · see citing works
Redefining precision cancer prevention to promote health equity
Butler, E. N., Umar, A., Heckman‐Stoddard, B. M., et al. (2022) · Trends in cancer · doi:10.1016/j.trecan.2022.01.009 · Cited by 14 · see citing works
Acceptability and Preference for Human Papilloma Virus Self-Sampling among Thai Women Attending National Cancer Institute
Ploysawang, P., Pitakkarnkul, S., Kolaka, W., Ratanasrithong, P., Khomphaiboonkij, U., Tipmed, C., Seeda, K., Pangmuang, P., & Sangrajrang, S. (2023) · Asian Pacific Journal of Cancer Prevention · doi:10.31557/apjcp.2023.24.2.607 · Cited by 13 · see citing works
“Several studies showed that women preferred clinician sampling over self-sampling because of a lack of confidence in performing the test (Williams et al., 2017; Nishimura et al., 2021).”
Background
Molecular triaging options for women testing HPV positive with self-collected samples
Taghavi, K., Zhao, F., Downham, L., Baena, A., & Basu, P. S. (2023) · Frontiers in Oncology · doi:10.3389/fonc.2023.1243888 · Cited by 14 · see citing works
“8) (8) and samples for self-collected hrHPV testing is well accepted by women in a range of different contexts (3, 8, 29), it is logical to offer this option in screening regimes.”
Background
Recent HPV self-sampling use for cervical cancer screening in Latin America and Caribbean: a systematic review
Dartibale, C. B., Prado, G. D. C., Carobeli, L. R., Meirelles, L. E. D. F., Damke, G. M. Z. F., Damke, E., Morelli, F., Souza, R. P., Group PREVENT YOURSELF, da Silva, V. R. S., et al. (2022) · Frontiers in Oncology · doi:10.3389/fonc.2022.948471 · Cited by 14 · see citing works
Qualitative assessment of attitudes toward cervical cancer (CC) screening and HPV self-sampling among African American (AA) and Sub Saharan African Immigrant (SAI) women
Adegboyega, A., Desmennu, A. T., & Dignan, M. (2021) · Ethnicity and Health · doi:10.1080/13557858.2021.1980771 · Cited by 12 · see citing works
“…have been identified among women globally, including the ability to perform the self-sampling correctly, fear of self-harm, lack of confidence in test accuracy, and concerns about self-sampling replacing gynecological visits (Howard et al. 2009; Berner et al. 2013; Nishimura et al. 2021).”
Background
Gaps in the screening process for women diagnosed with cervical cancer in four diverse US health care settings
Chao, C., Chubak, J., Beaber, E. F., et al. (2022) · Cancer Medicine · doi:10.1002/cam4.5226 · Cited by 11 · see citing works
Human papillomavirus self-sampling versus provider-sampling in low- and middle-income countries: a scoping review of accuracy, acceptability, cost, uptake, and equity
Otieno, J. A., Were, L. M., Nyanchoka, M., Olwanda, E. E., Mulaku, M., Sem, X., Kohli, M., Markby, J. L., Muriuki, A., & Ochodo, E. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1439164 · Cited by 15 · see citing works
Understanding the effect of new U.S. cervical cancer screening guidelines and modalities on patients’ comprehension and reporting of their cervical cancer screening behavior
Higashi, R. T., Tiro, J. A., Winer, R. L., et al. (2023) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2023.102169 · Cited by 11 · see citing works
Exploring factors associated with preferences for human papillomavirus (HPV) self-sampling among racially- and ethnically-diverse women in Minnesota: A cross-sectional study
Xiong, S., Ghebre, R. G., Kulasingam, S., Mason, S. M., Pratt, R. J., & Lazovich, D. (2023) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2023.102243 · Cited by 12 · see citing works
Are Canadian Women Prepared for the Transition to Primary HPV Testing in Cervical Screening? A National Survey of Knowledge, Attitudes, and Beliefs
Haward, B., Tatar, O., Zhu, P., Griffin-Mathieu, G., McBride, E., Waller, J., Brotherton, J. M. L., Lofters, A., Mayrand, M., Perez, S., et al. (2023) · Current Oncology · doi:10.3390/curroncol30070512 · Cited by 10 · see citing works
“This is consistent with extant findings that suggest fears about sample reliability and the collection procedure are the primary concerns of individuals using self-sampling [10,48,52].”
BackgroundResult
Community and provider perceptions and experiences of cervical cancer screening in Rural Bolivia: a qualitative study
Basagoitia, A., Burrowes, S., Solís-Soto, M. T., et al. (2023) · BMC Women s Health · doi:10.1186/s12905-023-02500-2 · Cited by 9 · see citing works
Assessment of PAX1 and JAM3 methylation triage efficacy across HPV genotypes and age groups in high-risk HPV-positive women in China
Hui, L., Liu, Y., Yin, S., et al. (2024) · Frontiers in Oncology · doi:10.3389/fonc.2024.1481626 · Cited by 9 · see citing works
“%) poses challenges in detecting high-grade lesions and contributes to potential underdiagnosis issues (32, 33).”
Design and Validation of a Chatbot-Based Cervical Cancer Screening Decision Aid for Women Experiencing Socioeconomic Disadvantage: User-Centered Approach Study
Bonniec, A. L., Sauvaget, C., Lucas, E., Nassiri, A., & Selmouni, F. (2025) · JMIR Cancer · doi:10.2196/70251 · Cited by 9 · see citing works
“Our results are in accordance with international evidence, showing that HPVss is generally acceptable to women, but a lack of self-confidence with collecting a reliable sample can be a barrier to choosing this option [7].”
Ensuring a Successful Transition From Cytology to Human Papillomavirus–Based Primary Cervical Cancer Screening in Canada by Investigating the Psychosocial Correlates of Women’s Intentions: Protocol for an Observational Study
Griffin-Mathieu, G., Haward, B., Tatar, O., Zhu, P., Perez, S., Shapiro, G. K., McBride, E., Thompson, E. L., Smith, L., Lofters, A., et al. (2022) · JMIR Research Protocols · doi:10.2196/38917 · Cited by 10 · see citing works
The levels of women’s awareness, experience, acceptability and preference for Vaginal Human Papillomavirus (HPV) self-sampling in three provinces of China: a cross-sectional study
Song, J., Ni, Y.-H., Fang, J., et al. (2024) · BMC Women s Health · doi:10.1186/s12905-024-03186-w · Cited by 8 · see citing works
“A global systematic evaluation reported a range of self-sampling choices from 50–93% [8].”
BackgroundResult
The Impact of Urine-Sample HPV Testing on the Effectiveness of Screening for Cervical Cancer: An Umbrella Review
Miazga, W., Tatara, T., Wnuk, K., et al. (2024) · Cancers · doi:10.3390/cancers16122244 · Cited by 8 · see citing works
“However, the second study did not directly compare the preference regarding the collection of urine samples with the preference regarding the self-sampling of vaginal swabs [11].”
Background
A New Brazilian Device for Cervical Cancer Screening: Acceptability and Accuracy of Self-sampling
Lichtenfels, M., Lorenzi, N. P. C., Tacla, M., Yokochi, K., Frustockl, F. C., Silva, C. A., da Silva, A. L., Termini, L., & de Farias, C. B. (2023) · Revista Brasileira Ginecologia e Obstetrícia · doi:10.1055/s-0043-1770134 · Cited by 10 · see citing works
“The studies evaluating other cervical collectors used HC2 assay to detect HPV-DNA (16,18,31,33,35,39,45,51,52,56,68,69 and 68) and swab, spatula/Cytobrush, cervix broom brush, and Digene sampler for cervicovaginal sampling.”
BackgroundInfluential
The acceptability of HPV vaginal self-sampling for cervical cancer screening in Latin America: A systematic review
Narvaez, L., Viviano, M., Dickson, C., & Jeannot, É. (2023) · Public Health in Practice · doi:10.1016/j.puhip.2023.100417 · Cited by 10 · see citing works
Acceptability of Anal Human Papillomavirus Home Self-Sampling and Clinician Sampling Among Sexual and Gender Minority Individuals in Milwaukee, Wisconsin: The Prevent Anal Cancer Self-Swab Study
Nitkowski, J., Giuliano, A. R., Ridolfi, T., et al. (2023) · LGBT Health · doi:10.1089/lgbt.2023.0012 · Cited by 8 · see citing works
“Similar to cervicovaginal HPV self-sampling for cervical cancer screening, 6–9 anal HPV self-sampling is emerging as a potential method to screen for anal cancer.”
The economic burden of cervical cancer on women in Uganda: Findings from a cross-sectional study conducted at two public cervical cancer clinics
Dau, H., Nankya, E., Naguti, P., Basemera, M., Payne, B. A., Vidler, M., Singer, J., McNair, A., AboMoslim, M., Smith, L., et al. (2024) · PLOS Global Public Health · doi:10.1371/journal.pgph.0002554 · Cited by 8 · see citing works
“One of the most demonstrated practical, efficient, and effective ways to achieve this is through a human papillomavirus (HPV)-based self-sampling program [39].”
Background
Accuracy and acceptability of self-sampling HPV testing in cervical cancer screening: a population-based study in rural Yunnan, China
Duan, R., Yang, H., Zhai, X., et al. (2025) · Scientific Reports · doi:10.1038/s41598-025-09292-5 · Cited by 7 · see citing works
“This acceptance rate was lower than those observed in more developed areas of China 16 and in some high-income countries 17 .”
Results from Two HPV-Based Cervical Cancer Screening-Family Planning Integration Models in Malawi: A Cluster Randomized Trial
Tang, J. H., Lee, F., Chagomerana, M., et al. (2023) · Cancers · doi:10.3390/cancers15102797 · Cited by 7 · see citing works
“HPV self-collection is highly acceptable among women, regardless of age, income, or country of residence [10], and is similarly accurate as provider-collected samples when highly sensitive hrHPV assays are used [11].”
Method
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
Goff, J. L., Duc-Banaszuk, A.-S. L., Lefeuvre, C., Pivert, A., Ducancelle, A., Pauw, H. D., Arbyn, M., Vinay, A., & Rexand-Galais, F. (2023) · Cancers · doi:10.3390/cancers15215163 · Cited by 8 · see citing works
“Women appear to appreciate and better accept self-sampling [4], preferring it over clinician-sampling [5].”
Background
Evaluating human papillomavirus ( HPV ) self‐sampling among Latinas in the United States: A systematic review
Cora‐Cruz, M. S., Martínez, O., Perez, S., & Fang, C. Y. (2024) · Cancer Medicine · doi:10.1002/cam4.70098 · Cited by 8 · see citing works
“45 In the present review, we did not observe any distinct patterns in preference for self-sampling by setting (clinic vs. home); however, the location of self-collection was not always specified or it was variable even within a particular study (e.g., self-sampling could be performed at the…”
Background
Evaluation of C-C Motif Chemokine Receptor 5 (CCR5) as a Sample Adequacy Control in HPV Molecular Diagnostics
Njoku, R. C., Martinelli, M., Giubbi, C., Marco, S. D., Torsello, B., d’Avenia, M., Sironi, M., Bianchi, C., & Cocuzza, C. E. (2024) · Diagnostics · doi:10.3390/diagnostics14192194 · Cited by 7 · see citing works
“Self-collected sampling has been widely accepted as a method of cervical screening, especially in low-income and middle-income countries [6–10].”
Method
A scoping review of evidence on routine cervical cancer screening in South Asia: investigating factors affecting adoption and implementation
Rajkhowa, P., Mathew, M., Fadra, R., Saha, S., Rakshitha, K., Narayanan, P., & Brand, H. (2024) · Cancer Causes & Control · doi:10.1007/s10552-024-01923-y · Cited by 7 · see citing works
Barriers and facilitators affecting presentation in women with early versus advanced stage cervical cancer
Boitano, T. K. L., Powell, M. A., Leath, C. A., Straughn, J. M., & Scarinci, I. C. (2022) · Gynecologic Oncology Reports · doi:10.1016/j.gore.2022.100950 · Cited by 7 · see citing works
Acceptability and Preferences of Dry HR HPV Self-Sampling Mailed Kits Among Canadian Women: A Cross-Sectional Study
Ruel-Laliberté, J., Jacob‐Wagner, M., Bestman‐Smith, J., et al. (2023) · Journal of Obstetrics and Gynaecology Canada · doi:10.1016/j.jogc.2023.02.012 · Cited by 7 · see citing works
Identifying optimum implementation for human papillomavirus self-sampling in underserved communities: A systematic review
Mackay, O., Lifford, K., Kalra, A., & Williams, D. (2024) · Journal of Medical Screening · doi:10.1177/09691413241274312 · Cited by 6 · see citing works
“A previous review found the home to be a highly acceptable setting for HPVSS, but women were found to prefer clinic-based sampling if sampling in the home meant they would not have access to an HCP. 26 Using CHWs combines the ben-e ﬁ ts of home-based self-sampling with the support and reassur-ance offered by a trusted…”
Influential
Quality Assurance in Cervical Cancer Screening: Evaluation of Sample Adequacy in HPV DNA Testing
d’Avenia, M., Dell’Anno, F., Martinelli, M., Santomauro, L., Njoku, R. C., Mühr, L. S. A., Iacobellis, M., & Cocuzza, C. E. (2025) · Journal of Medical Virology · doi:10.1002/jmv.70482 · Cited by 6 · see citing works
“Self ‐ sampling studies have shown that some women prefer clinician ‐ collected samples due to concerns about their ability to perform self ‐ collection correctly [41], highlighting the need for confidence ‐ building measures and quality assurance strategies.”
Cost‐effectiveness analysis of alternative screening strategies for the detection of cervical cancer among women in rural areas of Western Kenya
Lobin, C., Orang’o, O., Were, E. O., Muthoka, K., Singh, K., Allegri, M. D., Obermann, K., Doeberitz, M. V. K., & Bussmann, H. (2024) · International Journal of Cancer · doi:10.1002/ijc.35036 · Cited by 8 · see citing works
Cervical cancer disparities
Perkins, R. B., & Mitchell, E. (2023) · Journal of the National Medical Association · doi:10.1016/j.jnma.2023.02.006 · Cited by 6 · see citing works
Understanding the cervical cancer self-collection preferences of women living in urban and rural Rwanda
Nair, V., Dau, H., Vidler, M., AboMoslim, M., Mutamba, B., Scott, M., Nesbitt, Z., Deodatha, J., Byiringiro, S. D., Niyotwiringiye, C., et al. (2023) · PLOS Global Public Health · doi:10.1371/journal.pgph.0002135 · Cited by 6 · see citing works
Rural women's preferences for cervical cancer screening via HPV self-sampling: a discrete choice experiment study in chidamoyo, Hurungwe District, Zimbabwe
Dzobo, M., Dzinamarira, T., Strauss, M., & Mashamba-Thompson, T. P. (2024) · AJOG Global Reports · doi:10.1016/j.xagr.2024.100414 · Cited by 6 · see citing works
Agreement Between High-Risk Human Papillomavirus Testing in Paired Self-Collected and Clinician-Collected Samples from Cervical Cancer Screening in Spain
Ibáñez, R., Roura, E., Morey, F., Andújar, M., Pavón, M. Á., Acera, A., Bruni, L., & de Sanjosé, S. (2024) · Cancers · doi:10.3390/cancers17010063 · Cited by 5 · see citing works
“SS can be used to improve screening coverage [18] particularly for the underscreened women in whom the majority of cervical cancers are diagnosed [9,19].”
Proof of Concept Study: Comparability of Microbiome Diversity in Self- and Physician-Collected HPV-Positive and HPV-Negative Cervicovaginal Samples
Asensio-Puig, L., de Andrés-Pablo, Á., Khannous‐Lleiffe, O., Ibáñez, R., Acera, A., de Sanjosé, S., Gabaldón, T., Alemany, L., Bruni, L., & Pavón, M. Á. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms25115736 · Cited by 5 · see citing works
“In addition, the introduction of self-sampling collection for HPV testing has emerged as a safe, accessible approach, increasing participation among women who might otherwise avoid sample collection by clinicians, therefore enhancing access to the screening test [6–8].”
Background
A comparative study of self-collected versus clinician-collected specimens in detecting high-risk HPV infection: a prospective cross-sectional study
Parapob, N., Lekawanvijit, S., Tongsong, T., et al. (2024) · Obstetrics & Gynecology Science · doi:10.5468/ogs.24117 · Cited by 5 · see citing works
Direct-to-consumer testing – benefits for consumers, people with disease and public health
Hinzmann, R. (2023) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2023-0007 · Cited by 5 · see citing works
Experience and acceptability for HPV self-sampling among women in Jiangsu province, China: a cross-sectional survey
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“They cared about whether they carried out self-sampling correctly and about the accuracy of the test result (Williams et al. 2017, Nishimura et al. 2021).”
Background
Preferred Location for Human Papillomavirus Self-Sampling for Cervical Cancer Screening
Liebermann, E., Fontenot, H. B., Lim, E., Matsunaga, M., Zimet, G. D., & Allen, J. D. (2023) · Journal of Obstetric, Gynecologic & Neonatal Nursing · doi:10.1016/j.jogn.2023.05.114 · Cited by 6 · see citing works
Health Care Provider Willingness to Recommend Self-collected Tests for Human Papillomavirus: A Mixed Methods Examination of Associated Factors
Fontenot, H. B., Fuzzell, L. N., Brownstein, N. C., et al. (2024) · Women s Health Issues · doi:10.1016/j.whi.2024.05.005 · Cited by 5 · see citing works
‘I felt so empowered, respected and shame free.’ Let’s test for HPV participants’ experience of HPV primary screening
Rose, S. B., McBain, L., Garrett, S. M., Bell, R. A. R., Innes, C., Whaiti, S. T., Tino, A. B., & Sykes, P. H. (2024) · Journal of Primary Health Care · doi:10.1071/hc24118 · Cited by 5 · see citing works
Home-based urinary HPV self-sampling for the detection of cervical cancer precursor lesions: attitudes and preferences from Belgian females participating in the CASUS study
Hendrickx, J. O., Keer, S. V., Donders, G. G. G., Weyers, S., Doyen, J., Beyers, K., Rios-Cortes, A., Meers, N., Téblick, L., & Vankerckhoven, V. (2025) · Archives of Public Health · doi:10.1186/s13690-024-01490-3 · Cited by 5 · see citing works
“FVU offers advantages over other self-sampling meth-ods, such as lavage, brush, or tampon-based self-sampling, due to its non-invasive nature, ease of use, and the absence of penetrating procedures, which can enhance participant comfort and increase acceptance among diverse populations [23, 27–31].”
Self‐collected vaginal HPV samples for long‐term non‐attendees in the Swedish organized cervical cancer screening program
Sundqvist, A., Hellsten, C., Strander, B., Lindh, M., & Borgfeldt, C. (2025) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1111/aogs.15112 · Cited by 5 · see citing works
Cervical cancer elimination: what, how and WHO ?
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Self-Sampling Modality for Cervical Cancer Screening: Overview of the Diagnostic Approaches and Sampling Devices
Rakhat, A., Marat, А., Sakhipova, G., Sakko, Y., & Aimagambetova, G. N. (2026) · Sci · doi:10.3390/sci8010005 · Cited by 4 · see citing works
“…to screening, when the sample collection is performed by a clinician, usually faces many barriers, including a shortage of healthcare facilities, a lack of trained personnel, stigma, embarrassment, and cultural or logistical complications that prevent women from attending clinics [24,31,32,35–39].”
Influential
Sociodemographic characteristics associated with cervical cancer screening participation by send‐to‐all and opt‐in HPV self‐sampling: Who benefits? Results from a randomized controlled trial among long‐term non‐attending women in Norway
Hansen, B. T., Nygård, M., Castle, P. E., Burger, E. A., & Aasbø, G. (2024) · International Journal of Cancer · doi:10.1002/ijc.34989 · Cited by 4 · see citing works
“39 The sociodemographic profile of the present study population of long-term non-attending women differs from that of women in the general screening population.”
Plasma Thioredoxin Reductase as a Potential Biomarker for Gynecologic Cancer
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“Recent HPV selfsampling techniques identified by convenient, comfortable and private, dramatically increase screening coverage.(30) In addition, new screening methods, such as DNA ploidy analysis, methylation detection and p16/Ki-67 double staining, also facilitate the identification of cervical precancer, which are c…”
Method
The acceptability of group B streptococcal bacteria (GBS) testing to women, including self-swabbing procedures: A qualitative study
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“It Feels Like Health Care with the Patient in Mind”: VA Patient and Staff Perspectives on Self-Collected HPV Testing
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Incidence and duration of human papillomavirus infections in young women: insights from a bimonthly follow-up cohort
Bénéteau, T., Groc, S., Murall, C. L., et al. (2024) · Scandinavian Journal of Infectious Diseases · doi:10.1080/23744235.2024.2427223 · Cited by 4 · see citing works
HPV Testing Behaviors and Willingness to Use HPV Self-sampling at Home Among African American (AA) and Sub-Saharan African Immigrant (SAI) Women
Adegboyega, A., Wiggins, A. T., Williams, L. B., & Dignan, M. (2021) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-021-01184-4 · Cited by 4 · see citing works
Addressing COVID-19 Screening Delays: The Impact of HPV Self-Sampling on Non-Attenders in a Cervical Cancer Screening Program
Chiereghin, A., Pizzi, L., Buriani, C., Sanna, T., Amico, A., Squillace, L., Molinari, E., Florean, M. S., Lanza, G., & Mezzetti, F. (2024) · Cancers · doi:10.3390/cancers16234071 · Cited by 3 · see citing works
“The literature reports that the self-sampling method can increase screening participation across countries with varying income levels, including low-, middle-and high-income nations [7,8].”
General Practitioners’ Needs and Preferences Regarding the Provision of Self-sampling Tests for Cervical Cancer Screening in Flanders, Belgium
Gezels, E., Willems, S. J. T., Vanthomme, K., Keersse, L., & Roy, K. V. (2025) · Journal of Primary Care & Community Health · doi:10.1177/21501319251320178 · Cited by 3 · see citing works
“10,16,17 In several European countries SSKs are used in the population-based CCS program.”
A cross-sectional analysis of factors associated with cervical cancer screening in a large midwest primary care setting
Cyriac, J., Jenkins, G. D., Strelow, B., et al. (2025) · BMC Women s Health · doi:10.1186/s12905-025-03741-z · Cited by 3 · see citing works
“Reassuringly, high acceptability of self-collection for CCS was reported in a systematic review of 72 studies including just over 52,000 women, with no significant differences by factors such as income or age [55].”
A pay-it-forward approach to improve feedback rate of HPV-based self-sampling in cervical cancer screening among women in ethnic minority regions of China: a randomized controlled trial protocol
Zhou, X., Bao, R., Guan, X., Li, W., Yang, C., Zhu, R., Li, H., & Wang, X. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1586076 · Cited by 4 · see citing works
“Studies have shown that such mechanisms can signi ﬁ cantly enhance adherence to health screening programs by creating a sense of responsibility and investment among participants (35).”
Building the foundations for an organized population-based cervical cancer screening program with primary HPV self-sampling in Catalonia, Spain: findings from a pilot implementation study
Peremiquel‐Trillas, P., Roura, E., Rangel, V., Morey, F., Font, R., Carvajal, M., Robles, C., Ibáñez, R., Pijuán, L., Tamarit, L., et al. (2025) · Frontiers in Medicine · doi:10.3389/fmed.2025.1580665 · Cited by 4 · see citing works
‘ Why Didn't I Get That Choice?’ : A Qualitative Exploration of How Cervical Screening Choices Are Understood and Experienced by Screen‐Eligible People in Australia, Two Years After Self‐Collection Became an Option for All
Colling, A. M., Saunders, T., Creagh, N. S., et al. (2025) · Health Expectations · doi:10.1111/hex.70397 · Cited by 3 · see citing works
Health System Strategies to Improve the Uptake of Cervical Cancer Screening in Sub-Saharan Africa: A Scoping Systematic Review
Rivero‐Mendoza, D., Gjoka, K., Singh, L., et al. (2025) · Health Promotion Practice · doi:10.1177/15248399251370668 · Cited by 3 · see citing works
“HPV self-collection is well recognized as a strategy that improves screening results because it addresses barriers to screening, such as lack of convenience and privacy (Mkuu et al., 2024; Nishimura et al., 2021).”
Preferences Among U.S. Women for Cervical Cancer Screening with Self-Collected Specimens for Human Papillomavirus Testing
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Authors: Nishimura, H., Yeh, P. T., Oguntade, H., Kennedy, C. E., & Narasimhan, M.
Affiliations: Johns Hopkins University (US)
World Health Organization (CH)
Corresponding author: Nishimura, Holly
ORCID: Nishimura, Holly
Yeh, Ping Teresa
Oguntade, Habibat
Kennedy, Caitlin E
Narasimhan, Manjulaa
Venue: BMJ Global Health
Publisher: BMJ
Published: 2021-05
Volume: 6
Issue: 5
Pages: e003743
ISSN: 2059-7908 (ISSN-L)
DOI: 10.1136/bmjgh-2020-003743
PMC: PMC8137189
OpenAlex: W3163098986
Semantic Scholar: 230d785d63fd20da248338eef71b6ca8ac7b419f
Cited by: 222
References: 98
Citations by year: 2026: 53 · 2025: 57 · 2024: 46 · 2023: 39 · 2022: 17 · 2021: 10
FWCI: 5.90
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (unspecified, 18 d)
Locations: BMJ Global Health (publishedVersion, cc-by)
PubMed (publishedVersion)
PubMed Central (submittedVersion, cc-by)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders: World Health Organization
The Children's Investment Fund Foundation
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 self-sampling, cervical cancer screening, HPV testing, end-user preferences, acceptability, cervical swabs, clinician-collected samples, home-based screening, women's health
MeSH terms: Adolescent, Adult, Aged, Aged, 80 and over, Uterine Cervical Neoplasms, Cross-Sectional Studies, Female, Humans, Middle Aged, Self Care, Papillomaviridae, Papillomavirus Infections, Alphapapillomavirus, Early Detection of Cancer, Young Adult

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HPV self-sampling for cervical cancer screening: a systematic review of values and preferences

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