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Self-collected HPV testing improves participation in cervical cancer screening: a systematic review and meta-analysis.

2013; National Institutes of Health; Linguagem: Inglês

C. Sarai Racey, Diana R. Withrow, Dionne Gesink,

Reproductive tract infections research

HPV testing has emerged as an effective cervical cancer screening test. The use of HPV self-testing has the potential to address many barriers to screening and reach at-risk women through engagement in screening. However, there is a need to examine the evidence for whether offering self-collected HPV testing in practice increases screening compliance. The objective of this review is to determine to what extent providing self-collected HPV testing increases screening participation in women who are never or underscreened for cervical cancer.A systematic literature review conducted in the databases Medline and Embase identified articles examining the use of HPV self-testing on cervical cancer screening participation. A meta-analysis using a random-effects model was used to calculate the relative compliance, with an intent-to-treat analysis of HPV self-testing compared to Pap testing, with 95% confidence intervals (CI). All statistical tests were two-sided.Ten studies were reviewed, with 8 being European and 2 North American. Of the 10 studies, 9 employed a randomized design. In all studies, the relative compliance of HPV self-collected testing compared to Pap testing was significantly greater than 1.0 (p<0.01). The overall relative compliance was 2.14 (95% CI 1.30-3.52). There was large heterogeneity of screening compliance between studies for both HPV self-testing and Pap testing.HPV self-collected testing significantly improved the participation of women who did not routinely attend cervical cancer screening programs. New approaches to HPV self-test delivery should be considered as HPV testing becomes more widely incorporated as a primary screening tool.