Cost-effectiveness of self-sampling strategies for cervical cancer screening: a commentary

Tackling cervical cancer represents a global health priority and relies on preventative approaches such as screening. To increase uptake, self-sampling strategies used to detect human papillomaviruses have shown promise of cost-effectiveness. This commentary critically appraises an economic evaluation comparing first-void urine and vaginal swab self-sampling strategies against clinician-collected cervical samples in the UK. While the self-sampling strategies could improve screening uptake among non-attenders and health outcomes, the impacts on the subsequent incidence of cervical cancer and types of cancer stage for non-attenders should have been considered. Higher screening uptake, while increasing early detection, would also imply an increase in the number of diagnostic and follow-up appointments, for example for cytology and colposcopies. Future research should bridge these gaps as well as investigating the differential effects on socio-economic sub-groups and the views of eligible women to facilitate a wider implementation of self-sampling strategies.