Could HPV Testing on Self-collected Samples Be Routinely Used in an Organized Cervical Screening Program? A Modeled...

Area of Science:

• Gynecologic Oncology
• Public Health
• Epidemiology

Background:

• Cervical screening using self-collected samples has primarily targeted underscreened populations.
• Recent evidence confirms comparable sensitivity for PCR-based human papillomavirus (HPV) testing on both self-collected and clinician-collected samples.

Purpose of the Study:

• To model the lifetime impact of cervical screening using only self-collected samples.
• To compare this strategy against the current Australian program of 5-yearly HPV screening with clinician-collected samples.
• To evaluate outcomes in both HPV-vaccinated and unvaccinated cohorts.

Main Methods:

• A well-established modeling approach was employed.
• Lifetime cancer diagnoses and deaths were compared.
• Assumed 0.98 relative sensitivity for self-collected vs. clinician-collected samples.
• Evaluated scenarios with and without HPV vaccination and varying additional uptake rates.

Main Results:

• In unvaccinated cohorts, increased participation from self-collection compensated for minor sensitivity loss.
• In vaccinated cohorts, population-wide self-collection was more effective with higher (50%) additional uptake.
• Restrictions in the current Australian program (age 30+, ≥2 years overdue) significantly reduce effectiveness.

Conclusions:

• Potential minor losses in test sensitivity with self-collection are outweighed by improved program effectiveness due to increased uptake.
• Self-collection could be offered more broadly as an option for women.