A Critical Review of Human Papillomavirus Self-sampling: Evidence and Impact

Cervical cancer is a malignant neoplasm arising from the cervix and remains a significant public health concern, particularly in low- and middle-income countries (LMICs). Human papillomavirus (HPV) infection is among the most prevalent infections globally, with over 70% of the population estimated to be exposed at some point in their lifetime. Notably, approximately 99.7% of cervical cancer cases are attributable to persistent infection with high-risk HPV types. Cervical cancer is largely preventable through HPV vaccination and effective screening, but numerous barriers persist. The World Health Organization now recommends HPV testing as the primary screening modality due to its superior sensitivity and longer screening intervals compared to cytology or visual inspection with acetic acid. The test’s compatibility with self-sampling (SS) increases feasibility and acceptability among women, leading to broader coverage and improved participation. Ultimately, these features contribute to the prevention of a greater number of cervical precancers and cancers. SS for HPV testing has emerged as a highly effective and acceptable strategy for cervical cancer screening across diverse populations. By eliminating this requirement, SS significantly improves acceptability and participation, particularly among women who are hesitant or unable to access facility-based screening services. This patient-centered approach not only reduces healthcare costs and provider burden but also enhances screening coverage by reaching underscreened and hard-to-reach populations. These features contribute to the prevention of a greater number of cervical precancers and cancers. SS for HPV primary screening offers a valuable opportunity to enhance screening coverage, especially in low-resource settings where healthcare infrastructure and access to trained personnel are limited however further research is needed to establish best practices for SS implementation, including determining target populations, follow-up protocols, and education strategies to prepare both healthcare systems and the public.