Ping Teresa Yeh|Caitlin E. Kennedy|Hugo De Vuyst|Manjulaa Narasimhan
Self-sampling for human papillomavirus (HPV) testing: a systematic review and meta-analysis
Johns Hopkins University|Johns Hopkins University|International Agency For Research On Cancer
introduction human papillomavirus hpv selfsampling test kits may increase screening early detection cervical cancer reduce burden globally inform selfcare guidelines conducted systematic review metaanalysis hpv selfsampling among adult women cervical precancer screening uptake screening frequency social harmsadverse events linkage clinical assessmenttreatment methods included studies compared women using cervical cancer screening services hpv selfsampling women using standard care measured least one outcome published peerreviewed journal searched pubmed cumulative index nursing allied health literature cniahl latin american caribbean health sciences literature lilacs embase october 2018 risk bias assessed using cochrane tool randomised controlled trials rcts evidence project tool nonrandomised studies metaanalysis conducted using randomeffects models generate pooled estimates relative risk rr results 33 studies 34 articles 369 017 total participants met inclusion criteria 29 rcts 4 observational studies studies examined hpv selfsampling comparison groups standard care eg pap smear visual inspection acetic acid cliniciancollected hpv testing 93 participants highincome countries 33 studies measured cervical cancer screening uptake metaanalysis found greater screening uptake among hpv selfsampling participants compared control rr 213 95 ci 189 240 effect size varied hpv test kit dissemination method whether mailed directly home rr 227 95 ci 189 271 offered doortodoor rr 237 95 ci 112 503 requested demand rr 128 95 ci 090 182 metaanalysis showed statistically significant difference linkage clinical assessmenttreatment arms rr 112 95 ci 080 157 studies measured screening frequency social harmsadverse events conclusion growing evidence base mainly highincome countries significant heterogeneity suggests hpv selfsampling increase cervical cancer screening uptake compared standard care marginal effect linkage clinical assessmenttreatment systematic review registration number prospero crd42018114871