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The acceptability of self-sampled screening for HPV DNA: a systematic review and meta-analysis
  1. Erik J Nelson1,
  2. Brandy R Maynard2,
  3. Travis Loux3,
  4. Jessica Fatla1,
  5. Rebecca Gordon1,
  6. Lauren D Arnold1
  1. 1Department of Epidemiology, College for Public Health and Social Justice, St Louis, Missouri, USA
  2. 2School of Social Work, College for Public Health and Social Justice, St Louis, Missouri, USA
  3. 3Department of Biostatistics, College for Public Health and Social Justice, St Louis, Missouri, USA
  1. Correspondence to Professor Erik J Nelson, Department of Epidemiology, College for Public Health and Social Justice, 3545 Lafayette Avenue, Room 472, St Louis, MO 63104, USA; nelsonej{at}


Objective To examine whether or not self-sampled cervical screening for human papillomavirus (HPV) DNA is acceptable and if women prefer self-sampling to clinician-based sampling.

Design Systematic review and meta-analysis.

Data sources Thirty-seven primary studies obtained through a comprehensive search of six electronic bibliographic databases from 1986 to 2014 and other sources. Search keywords included HPV, screening, DNA testing, vaginal testing, self-collected specimen, self-collected sample, self-sampling, self-screening, preferences and acceptability.

Review methods Studies eligible for analysis included those that had participants perform self-sampling, evaluated participant acceptance of or preference for self-sampled vaginal HPV DNA and reported data to calculate an effect size. There were no exclusion criteria for publication status or geographical location. Meta-analytic methods were used to quantitatively synthesise effect sizes across studies.

Results The 37 studies included 18 516 female participants from 24 countries across five continents. Overall, there was a high level of acceptability of self-sampling among the participants. Participants reported preference for self-sampling over clinician sampling due to attractive characteristics such as ease and privacy.

Conclusions The overall acceptability of self-sampled cervical screening, coupled with economic and effective care, provides opportunities for expanding screening services. Importantly, this can provide a creative screening alternative for women who do not participate in traditional cytological screening, and may ultimately reduce health disparities and prevent cervical disease.

  • HPV

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  • Handling editor Jackie A Cassell

  • Twitter Follow Brandy Maynard at @BrandyRMaynard

  • Contributors EJN conceived and designed the study. EJN, BRM and LDA drafted the manuscript. TL conducted the statistical analyses. BRM, LDA, TL, JF and RG assisted in study design. All authors participated in editing the manuscript and approved the final protocol.

  • Competing interests LDA owns <$5000 of stock in Merck.

  • Provenance and peer review Not commissioned; externally peer reviewed.