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Cited by 0Cervical Cancer and HPV ResearchWomen's cancer prevention and managementHealth Policy Implementation Science

Integrating behavioural science into HPV self-sampling and cervical cancer elimination strategies

Open access
Devotta, Kimberly, Lofters, Aisha, Sayani, Ambreen, Shapiro, Gilla K.·2026·Women's Health
DOI 10.1177/17455057261484755
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Abstract

Cervical cancer is highly preventable through regular screening and vaccination. The World Health Organization and governments worldwide have identified the elimination of cervical cancer as a public health problem, as an attainable goal, representing a major advancement in women’s health. While screening has traditionally relied on the Papanicolaou test (Pap test), evidence shows that HPV DNA testing is more accurate in detecting cervical precancers. HPV testing can be performed using clinician-collected or self-collected samples, with self-sampling shown to improve screening access and uptake across diverse populations (e.g., racial or ethnic minority persons, gender minority persons, newcomers) and settings (e.g., rural areas, geographically hard to reach). Despite this potential, several behavioural, structural, and system-level barriers continue to limit widespread uptake of HPV self-sampling. In this work, we argue that behavioural science is central to addressing these barriers. We apply the Capability, Opportunity, Motivation-Behaviour (COM-B) model to identify key barriers and propose multi-level, theory-informed strategies that span individuals, healthcare providers, and health systems to enhance the capability, opportunity, and motivation of women and people with a cervix (WPC) to engage in HPV self-sampling. Targeted education, coaching, strong provider-patient engagement, accessible kit distribution and return pathways, and meaningful community involvement may collectively strengthen uptake of HPV self-sampling and accelerate progress toward global cervical cancer elimination.

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Research works printed but not linked: 1

  1. WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention: use of dual-stain cytology to triage women after a positive test for human papillomavirus (HPV). Geneva: World Health Organization. WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention, second edition. Licence: CC BY-NC-SA 3.0 IGO; 2024.

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Authors
Devotta, K., Lofters, A., Sayani, A., & Shapiro, G. K.
Affiliations
  • Women's College Hospital (CA)
  • Women's College Research and Innovation Institute, Women’s College Hospital,
  • University of Toronto (CA)
  • University Health Network (CA)
Corresponding author
Devotta, Kimberly
ORCID
Venue
Women's Health
Publisher
SAGE Publications
Published
2026-10
Volume
22
Pages
17455057261484755-17455057261484755
ISSN
  • 1745-5057 (ISSN-L)
  • 1745-5065
DOI
10.1177/17455057261484755
OpenAlex
W7220899355
Cited by
0
References
28
Type
journal article
Language
en
Open access
Licence
Locations
  • Women s Health (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Keywords
HPV self-sampling, cervical cancer elimination, HPV testing, cervical cancer screening, behavioral science, COM-B model, screening uptake barriers, health system access, community participation
MeSH terms
Human Papillomavirus Viruses, Uterine Cervical Neoplasms, Female, Humans, Health Knowledge, Attitudes, Practice, Mass Screening, Patient Acceptance of Health Care, Self Care, Specimen Handling, Vaginal Smears, Papillomavirus Infections, Early Detection of Cancer, Papanicolaou Test

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