What are the potential benefits and harms of self-sampling?
In theory, this method offers benefits to women with no access to a health care provider, who are uncomfortable with physical examination, or whose values prohibit an examination by a male physician. No studies evaluated the impact of self-sampling for human papillomavirus (HPV) testing on participation rates in cervical screening, early detection of cervical cancer, survival, or quality of life.
Is it feasible for women to successfully perform self-sampling?
Women in many countries, across a range of ages, were successful in collecting samples for HPV testing using a variety of self-collection techniques (e.g., swabs, brushes, tampons, lavage, and pads).
With self-sampling, are samples obtained by women adequate for analysis?
The quality of the patient samples was as good as the clinician samples, with more than 95% of samples yielding HPV testing results.
What is the accuracy of self-sampling?
Evidence on the accuracy of self-sampling for HPV testing was available from 14 studies, but interpretation is hampered by incomplete colposcopy data from with negative HPV tests. A wide range of sensitivity and specificity values were observed among both patient- and clinician-collected samples, but the sensitivity of self-collection methods appeared to be slightly lower than that for samples collected by clinicians. Eleven of 19 studies found reasonable agreement (kappa>0.6) between the HPV test results from self- and physician-collected samples.
Is self-sampling acceptable to women?
The majority of women were willing to perform self-sampling, did not find it difficult or painful, and preferred self-sampling to physician sampling.
Is self-sampling appealing to women?
One study reported that women were more comfortable and less embarrassed with self-sampling than with physician sampling but wanted assurance that self-collection of HPV samples would not make them ineligible for physician visits for other concerns.
Do specific characteristics of women influence preferences regarding self-sampling?
There is little evidence about which women are interested in, or willing to perform, self-sampling.
Is self-sampling appropriate for women who are never or seldom screened by clinicians?
Findings from one study suggested that written self-sampling instructions might be hard to follow for women with limited education; however, among that group of women, their requests for graphics or practice sessions in the clinic were seen as possible solutions to aid sample collection.
