Accuracy of self-collection in human papillomavirus-based cervical screening: An evidence-based review

As there is a large body of evidence confirming its accuracy, human papillomavirus (HPV) self-collection has been introduced to the Australian National Cervical Screening Program (NCSP). Self-collection also offers an opportunity to engage under-screened (including never‑screened) individuals. Under-screening remains a significant risk factor for cervical cancer, with over 70% of Australian cases involving individuals who are under‑screened or have never been screened.

This article provides an in-depth, evidence-based examination of the clinical accuracy of self-collection in cervical screening and provides recommendations for general practice. The discussion also includes a brief overview of self-collection adoption in under- and never-screened people.

Many studies have demonstrated that self-collection is similar to clinician-collection for detecting clinically significant HPV infections. However, some general practitioners (GPs) still have concerns about self‑collection, including holding the misconception that self-collection is less accurate, possibly because of older studies that were undertaken using less sensitive testing technologies. Understanding self-collection accuracy, devices, quality control methods and the implications for general practice can encourage GPs to offer it to eligible patients, potentially engaging more patients in cervical screening, preventing devastating diagnoses, increasing equity and saving lives.