2026 · International journal of cancer · open access
Under which realistic circumstances is hrHPV self-sampling increasing cervical screening effectiveness in a partly vaccinated population? A modelling study
Kaljouw et al.
The finding, in our words
Modelling showed HPV self-sampling improves screening effectiveness only by reaching non-attenders; with 10% non-attenders reached, switchers must stay below 40% to maintain life-year gains, but with 30% reached, up to 100% may switch. Cost-effectiveness depends on reducing waste from unused kits.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
Vaginal self-sampling devices detect HPV with high sensitivity, 94.6% for brushes and 82.9–100% for tampons, while improving patient comfort and reducing costs by 32–48% in resource-limited settings, supporting patient-centric cervical cancer screening programmes.
Routine clinic-based cervical sampling generated 3670 g CO2e per sample, whereas vaginal self-sampling produced 423 g CO2e and first-void urine collection produced 570 g CO2e. Decentralised self-collection approaches substantially lowered emissions by eliminating primary care clinic visits.
Whittaker et al., BJOG : an international journal of obstetrics and gynaecology (paywalled) · source ↗
First-void urine self-sampling for HPV screening cost £38.57 per complete screen compared with £56.81 for clinician-collected samples, with potential NHS savings of £19.2 million annually if uptake improved among non-attenders. This shows self-sampling is substantially cheaper and could expand screening reach to under-screened women, supporting decentralised diagnostic programmes.
Urine self-sampling for HPV detection showed good agreement with clinician-collected cervical samples (Kappa 0.72) under optimised conditions of 40 mM EDTA preservative, storage at 25°C, and processing within 72 hours. With a cost of USD 1.10 and high acceptability among women and healthcare workers, this method offers a practical decentralised screening approach for resource-limited settings.
The trial found that pre-invitation leaflets and online booking did not increase cervical screening uptake among young women, while HPV vaccination status was associated with higher attendance. Sending vaginal self-sampling kits to non-attenders at six months was identified as a potentially cost-effective strategy, although the overall net impact of interventions was small. This matters because it demonstrates the limited effect of early invitations and highlights the potential value of targeted, delayed self-sampling offers in decentralised screening programmes.
Kitchener et al., Health technology assessment · source ↗