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A meta-analysis of 56 accuracy studies and 25 randomised trials found that self-sampled swabs tested with PCR detect precancer as well as clinician-taken samples, and mailing kits to under-screened women roughly doubles participation.
Arbyn and colleagues pooled diagnostic accuracy studies comparing HPV testing on self-collected versus clinician-collected samples, and randomised trials comparing strategies to reach under-screened women.
With PCR-based assays, sensitivity for CIN2+ and CIN3+ on self samples was equivalent to clinician samples (relative sensitivity 0.99) and specificity was marginally lower (0.98). Signal-amplification assays performed worse on self samples. Mailing self-sampling kits to all under-screened women increased participation more than twofold compared with an invitation letter, as did door-to-door offers; opt-in kits produced smaller gains.
The findings underpin WHO and national guidance that self-sampling is an acceptable primary screening method.
Women can collect their own screening sample at home with no loss of accuracy if the laboratory uses a PCR test. Sending kits directly is the most effective way to reach women who do not attend, which matters because most cervical cancers occur in under-screened women.
Shares HPV DNA testing and self-sampling, HPV & HBV vaccination, Prevention we already have is not deployed, The hardest cancers are found late.
Shares Same-day HPV test and heat treatment of precancer by nurses in low-income settings, HPV self-testing with same-day treatment as the national cervical programme, HPV DNA testing and self-sampling, HPV & HBV vaccination.
Shares HPV DNA testing and self-sampling, HPV & HBV vaccination, Prevention we already have is not deployed, The hardest cancers are found late.
Shares HPV DNA testing and self-sampling, HPV & HBV vaccination, Prevention we already have is not deployed, Most of the world has almost no cancer care.
Shares HPV DNA testing and self-sampling, HPV & HBV vaccination, Prevention we already have is not deployed, Most of the world has almost no cancer care.
Shares HPV & HBV vaccination, Prevention we already have is not deployed, Most of the world has almost no cancer care, Cervical cancer.
Shares HPV & HBV vaccination, Prevention we already have is not deployed, Most of the world has almost no cancer care, Cervical cancer.
Shares HPV DNA testing and self-sampling, HPV & HBV vaccination, Prevention we already have is not deployed, Most of the world has almost no cancer care.
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