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Cost and cost-effectiveness of cervical cancer HPV DNA self-sampling: a systematic review
Novatus Apolinary Tesha1,2, Nishant Jaiswal2, George Ruhago1
1Department of Development Studies, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of.
Objective:
To gather evidence on the costs and cost-effectiveness of human papillomavirus DNA (HPV DNA) self-sampling worldwide and to determine whether these are influenced by the various HPV DNA self-sampling strategies employed.
Design:
A systematic review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Data Sources:
Articles were searched from Embase, Medline (Ovid), PubMed and EconLit, published from 2015 to 2025.
Eligibility Criteria:
Women eligible for cervical cancer screening. Studies on the economic evaluation of HPV DNA self-sampling worldwide. Peer-reviewed original articles published in English from 2015 to October 2025.
Data Extraction:
Data were extracted using the authors' developed template. Analysis was done descriptively, applying synthesis without meta-analysis (SWiM).
Results:
33 studies were included in 11 low- and middle-income countries (LMICs) and 9 high-income countries (HICs). Most studies (N=18) targeted women from the general population and 10 under/never-screeners. The HPV DNA self-sampling strategies include: opt-in, opt-out, point of care and community health campaigns. Community health campaigns were predominant in LMICs, while opt-in and opt-out in HICs. The cost per woman screened reported in micro-costing/cost-consequence analysis studies ranged from US$31.77 to US$72.20 in LMICs and from US$56.21 to US$78.34 in HICs. 21/23 studies found HPV DNA self-sampling strategies to be cost-effective/cost-saving: 11/12 from LMICs and 10/11 from HICs.
Conclusions:
Community health campaigns and point-of-care HPV DNA self-sampling strategies in LMICs and opt-in and opt-out in HICs are cost-effective. Implementation studies are recommended, especially for populations at high risk.
Prospero Registration Number:
CRD42024518867.