Self-Sampling for Cervical Cancer: a Scoping Review
DOI:
https://doi.org/10.59141/jiss.v6i8.1839Keywords:
HPV self-sampling, cervical cancer screening, behavioral interventions, triage strategies, scoping reviewAbstract
Cervical cancer remains a major global health concern, particularly in low- and middle-income countries (LMICs), where barriers such as limited healthcare access, cultural stigma, and logistical challenges hinder routine screening. Human papillomavirus (HPV) self-sampling has emerged as a promising alternative to clinician-collected sampling, offering the potential to improve screening coverage and reduce the burden of cervical cancer. This scoping review aims to synthesize current evidence on the feasibility, effectiveness, and acceptability of HPV self-sampling, with a focus on its impact on screening uptake, psychological outcomes, and diagnostic accuracy. Following the PRISMA-ScR guidelines, a systematic search was conducted across PubMed, Google Scholar, and Scopus, resulting in the inclusion of five studies: four randomized controlled trials and one umbrella review. Findings indicate that self-sampling reduces anxiety associated with cervical screening, improves participation among underserved populations, and demonstrates high diagnostic concordance with clinician-collected samples. Behavioral interventions, such as pay-it-forward models, show potential to enhance sample return and feedback rates. However, challenges remain regarding effective triage strategies for HPV-positive cases, especially in resource-limited settings. The review supports the integration of self-sampling into national screening programs, emphasizing the need for culturally tailored approaches and continued research on cost-effective triage methods.
References
Arbyn, M., Verdoodt, F., Snijders, P. J., Verhoef, V. M., Suonio, E., Dillner, L., Minozzi, S., Bellisario, C., Banzi, R., Zhao, F. H., Hillemanns, P., & Anttila, A. (2014). Accuracy of human papillomavirus testing on self-collected versus clinician-collected samples: A meta-analysis. The Lancet Oncology, 15(2), 172–183. https://doi.org/10.1016/S1470-2045(13)70570-9
Chaw, L., Lee, S. H. F., Ja'afar, N. I. H., Lim, E., & Sharbawi, R. (2022). Reasons for non-attendance to cervical cancer screening and acceptability of HPV self-sampling among Bruneian women: A cross-sectional study. PLoS One, 17(3), e0262213. https://doi.org/10.1371/journal.pone.0262213
de Sanjosé, S., Brotons, M., & Pavón, M. A. (2018). The natural history of human papillomavirus infection. Best Practice & Research Clinical Obstetrics & Gynaecology, 47, 2–13. https://doi.org/10.1016/j.bpobgyn.2017.08.015
Garland, S. M., Kjaer, S. K., Muñoz, N., Block, S. L., Brown, D. R., DiNubile, M. J., Lindsay, L., Kuter, B., Perez, G., Dominiak-Felden, G., Saah, A. J., & Joura, E. A. (2016). Impact and effectiveness of the quadrivalent human papillomavirus vaccine: A systematic review of 10 years of real-world experience. Clinical Infectious Diseases, 63(4), 519–527. https://doi.org/10.1093/cid/ciw354
Ibáñez, R., Roura, E., Acera, A., Andújar, M., Pavón, M. À., Bruni, L., & de Sanjosé, S. (2023). HPV self-sampling among cervical cancer screening users in Spain: A randomized clinical trial of on-site training to increase the acceptability. Preventive Medicine, 173, 107571. https://doi.org/10.1016/j.ypmed.2023.107571
Levac, D., Colquhoun, H., & O'Brien, K. K. (2010). Scoping studies: Advancing the methodology. Implementation Science, 5, 69. https://doi.org/10.1186/1748-5908-5-69
Manley, K., Patel, A., Pawade, J., Glew, S., Hunt, K., Villeneuve, N., Mukonoweshuro, P., Thompson, S., Hoskins, H., López-Bernal, A., & Wills, A. (2022). The use of biomarkers and HPV genotyping to improve diagnostic accuracy in women with a transformation zone type 3. British Journal of Cancer, 126(1), 91–99. https://doi.org/10.1038/s41416-021-01539-y
Mekuria, S. F., Biazin, H., Abebe, T., Borgfeldt, C., Assegid, N., Mihret, A., Obsi Nemomsa, R., Forslund, O., & Jerkeman, M. (2024). Comparing visual inspection with acetic acid, with and without Lugol's iodine for triage of HPV self-sample positive women in Ethiopia: A randomized controlled trial. International Journal of Gynecological Cancer, 34(11), 1691–1697. https://doi.org/10.1136/ijgc-2024-005694
Melief, C. J. M., van Hall, T., Arens, R., Ossendorp, F., & van der Burg, S. H. (2020). Therapeutic cancer vaccines. The Journal of Clinical Investigation, 130(5), 2752–2762. https://doi.org/10.1172/JCI129197
Nelson, E. J., Maynard, B. R., Loux, T., Fatla, J., Gordon, R., & Arnold, L. D. (2017). The acceptability of self-sampled screening for HPV DNA: A systematic review and meta-analysis. Sexually Transmitted Infections, 93(1), 56–61. https://doi.org/10.1136/sextrans-2016-052609
Polman, N. J., de Haan, Y., Veldhuijzen, N. J., Heideman, D. A. M., de Vet, H. C. W., Meijer, C. J. L. M., Massuger, L. F. A. G., van Kemenade, F. J., & Berkhof, J. (2019). Experience with HPV self-sampling and clinician-based sampling in women attending routine cervical screening in the Netherlands. Preventive Medicine, 125, 5–11. https://doi.org/10.1016/j.ypmed.2019.04.025
Sen, O., & Yilmaz, T. (2025). The effect of self-sampling or clinician-based sampling on anxiety in cervical cancer screening among women: A randomized controlled trial. Journal of Obstetrics and Gynaecology Canada, 47(2), 103052. https://doi.org/10.1016/j.jogc.2025.103052
Tricco, A. C., Lillie, E., Zarin, W., O'Brien, K. K., Colquhoun, H., Levac, D., Kasperavicius, D., Straus, S. E., Moher, D., & Peters, M. D. J. (2018). PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Annals of Internal Medicine, 169(7), 467–473. https://doi.org/10.7326/M18-0850
Trimble, C. L., Morrow, M. P., Kraynyak, K. A., Shen, X., Dallas, M., Yan, J., Lamadrid, L., Cooch, N., Heinzerling, R. H., Calderon, B. M., Boyer, J. D., Tran, T. M., Yang, Y., Patel, A., Xiao, H., Brave, A., Marchand, C., Young, L., Rush, J., ... Weiner, D. B. (2015). Safety, efficacy, and immunogenicity of VGX-3100, a therapeutic synthetic DNA vaccine targeting HPV 16 and 18 E6 and E7 proteins for cervical intraepithelial neoplasia 2/3: A randomised, double-blind, placebo-controlled phase 2b trial. The Lancet, 386(10008), 2078–2088. https://doi.org/10.1016/S0140-6736(15)60266-1
World Health Organization. (2021). WHO guidelines for screening and treatment of precancerous lesions for cervical cancer prevention. https://www.who.int/publications/i/item/9789240030824
Zehbe, I., Wakewich, P., King, A. D., Morrisseau, K., & Tuck, C. (2017). Self-administered versus provider-directed sampling in the Anishinaabek Cervical Cancer Screening Study (ACCSS): A qualitative investigation with Canadian First Nations women. BMJ Open, 7(8), e017384. https://doi.org/10.1136/bmjopen-2017-017384
Zhou, X., Bao, R., Guan, X., Wang, Y., Liu, M., Li, H., Zhang, L., Chen, S., & Wang, J. (2025). A pay-it-forward approach to improve feedback rate of HPV-based self-sampling in cervical cancer screening among women in ethnic minority regions of China: A randomized controlled trial protocol. Frontiers in Psychiatry, 16, 1586076. https://doi.org/10.3389/fpsyt.2025.1586076
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Aditya Krishna Murthi, Yani Kurniawan, Imelda Yunitra, Catherine Halim, Sisca

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-ShareAlike 4.0 International. that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.








