Cited by 85Cervical Cancer and HPV ResearchWomen's cancer prevention and managementReproductive tract infections research

HPV-Based Self-Sampling in Cervical Cancer Screening: An Updated Review of the Current Evidence in the Literature

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Daponte, Nikoletta, Valasoulis, George, Michail, Georgios, Magaliou, Ioulia, Daponte, Athina-Ioanna, Garas, Antonios, Grivea, Ioanna, Bogdanos, Dimitrios P. +1 more·2023·Cancers

Abstract

Identifying and reaching women at higher risk for cervical cancer is all-important for achieving the ambitious endpoints set in 2020 by the WHO for global cervical cancer control by 2030. HPV-based (vaginal) self-sampling (SS) represents a cost-effective screening strategy, which has been successfully implemented during the last decade both in affluent and constrained settings. Among other advantages, SS strategies offer convenience, diminished costs, flexibility to obtain a sample in the office or home, avoiding a pelvic exam and uncomfortable appointment with a healthcare professional, as well as social and cultural acceptability. SS implementation has been globally boosted during the COVID-19 pandemic. In pragmatic terms, social distancing, local lockdowns, discontinuation of clinics and reallocation of human and financial resources challenged established clinician-based screening; self-collection strategies apparently surpassed most obstacles, representing a viable and flexible alternative. With time, sufficient reassuring data has accumulated regarding specially designed SS devices, aspects of sample preparation, transport and storage and, importantly, optimization of validated PCR-based HPV testing platforms for self-collected specimens. Suboptimal rates of clinical follow-up post-SS screening, as well as overtreatment with reliance solely on molecular assays, have both been documented and remain concerning. Therefore, effective strategies are still required to ensure linkage to follow-up testing and management following positive SS results by trained health professionals with knowledge of HPV biology and management algorithms. Because of the prolonged SS screening intervals, implementation data are limited regarding subsequent screening rounds of SS-screened individuals; however, these are accumulating gradually. With further refinement of assays and validation of novel biomarkers in self-collected samples, there is a clear potential for increasing SS accuracy and PPV. The potential differentiation of self-collection protocols for vaccinated versus non-vaccinated individuals also represents an open issue. In conclusion, HPV-based self-collection techniques can effectively address limited uptake alongside other conventional cervical screening drawbacks; however, assays, logistics and infrastructures need further optimization to increase the efficacy, effectiveness and cost-effectiveness of SS approaches.

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  1. [56]WHO WHO Guideline on Self-Care Interventions for Health and Well Being, 2022 Revision World Health Organization Geneva, Switzerland 2022 Volume 181 35914064

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Authors
Daponte, N., Valasoulis, G., Michail, G., Magaliou, I., Daponte, A.-I., Garas, A., Grivea, I., Bogdanos, D. P., & Daponte, A.
Affiliations
  • University of Thessaly (GR)
  • University of Patras (GR)
Corresponding author
Daponte, Alexandros
Venue
Cancers
Publisher
MDPI AG
Published
2023-03-08
Volume
15
Issue
6
Pages
1669
ISSN
2072-6694 (ISSN-L)
OpenAlex
W4323665208
Cited by
84
References
63
Citations by year
2026: 18 · 2025: 33 · 2024: 26 · 2023: 7
FWCI
3.28
Type
journal article
Language
en
Open access
Locations
  • Cancers (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
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
cervical cancer screening, vaginal self-sampling, HPV testing, COVID-19 pandemic, overtreatment, HPV vaccination, screening uptake, cost-effectiveness, sample storage and transport

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