HPV Self-Sampling for Primary Cervical Cancer Screening: A Review of Diagnostic Test Accuracy and Clinical Evidence – An Update [Internet]

Excerpt

The introduction of cervical cancer screening and timely intervention is associated with the recent decrease in cervical cancer incidence. There are several options to screen cervical cancer. Two of the methods commonly used in Canada are cytology and human papillomavirus (HPV) tests. Cytology requires clinicians to obtain samples from the cervix for further examination. HPV tests that detect the infection of HPV also requires samples from the cervix. The HPV tests that detect certain types of carcinogenic HPV genotypes, especially genotypes 16 and 18, are called high-risk HPV tests. The samples can be obtained via brushes or swabs or other devices not only by clinicians, but also by screening participants. Clinician-sampled HPV tests are used in screening program in several countries, such as Italy and Denmark. Self-sampled HPV tests have been tested in the capital region in Denmark but have not replaced clinician-sampled tests.

With feasibility to conduct at home and potentially better acceptability to participants, self-sampled HPV tests have been used to reach individuals that are unscreened or under-screened for cervical cancer. In a previous CADTH report, there was some evidence to show similar diagnostic test accuracy between self- and clinician-sampled HPV tests. For example, the diagnostic test accuracy of GP5+/6+ polymerase chain reaction (PCR) HPV tests using samples taken with brushes is similar for self- and clinician-collected samples. In several primary studies, fair to high agreement between self- and clinician-sampled HPV tests has been found.

Since the previous CADTH review, there have been primary studies comparing self- and clinician-sampled HPV tests published^, and a systematic review has been updated. This report updates the previous review on the difference in the diagnostic test accuracy of self-sampled HPV tests and the agreement between self- and clinician-sampled HPV tests.