Original Title: Uso de la auto-toma para determinación del Virus del Papiloma Humano en el programa de cribado de cáncer de cérvix

Authors' objectives: 1) To compare the diagnostic accuracy of self-sampling compared to that of clinician-collected samples for the detection of high-risk HPV strains for identifying grade 2 or 3 cervical intraepithelial neoplasia (CIN 2 or 3 respectively). 2) To assess the performance of self-sampling compared to that of other existing screening methods as a primary strategy for cervical cancer screening. 3) To describe the preferences of women regarding the use of HPV self-sampling as a screening method.

Authors' results and conclusions: The detection of HPV by self-sampling using signal amplification methods is likely to be less sensitive and may be less specific than clinician sampling for CIN 2. In the case of CIN 3, self-sampling may be less sensitive but there may be little or no difference in terms of specificity compared to clinician sampling. On the other hand, the detection of HPV by self-sampling using polymerase chain reaction (PCR) methods shows little or no difference in terms of sensitivity, and similarly, there may be little or no difference in terms of specificity, for identifying CIN 2 or 3 lesions, compared to clinician sampling. The strategy of screening by self-sampling is probably more efficient than a screening program based on clinician-collected samples for the detection of DNA from high-risk HPV strains, regardless of whether there is a prior cytology-based screening and HPV vaccine coverage. The potential benefits of moving towards an HPV detection program using self-sampling rely on the expectation that participation rates will increase by at least 6% and that the sensitivity will not be more than 5% lower than that observed with clinician-collected samples. It also implies that the recommended type of analysis is PCR and that measures should be taken to encourage participation in screening programs. The majority of women consider the use of self-sampling as a method for obtaining a cervicovaginal sample for detecting HPV DNA to be acceptable and that self-sampling is easy to perform. Further, the majority of women would prefer this sampling method to the collection of samples by a clinician. Conclusions HPV self-sampling for detecting HPV using PCR has few or no differences compared to clinician sampling in terms of sensitivity and specificity for CIN 2 and CIN 3. Self-sampling-based screening is probably more efficient than clinician-sampling-based screening programs for detecting DNA from high-risk HPV strains, provided that PCR is used for the analysis and measures are put in place to encourage greater participation in screening programs. Most women consider cervicovaginal self-sampling for detecting DNA from HPV acceptable and that the procedure is easy. Moreover, most would prefer self-sampling to clinician sampling.

Authors' methods: Systemic reviews were conducted, following the Cochrane Handbook for Systematic Reviews of Interventions.

Project Status: Completed

Year Published: 2024

URL for published report: https://www.euskadi.eus/contenidos/informacion/osteba_publicacion/eu_def/adjuntos/175_2021_OSTEBA_Papiloma_Cribado_Cancer_Cervix.pdf

English language abstract: An English language summary is available

Publication Type: Mini HTA

Country: Spain

Organisation Name: Basque Office for Health Technology Assessment

Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz

Contact Name: Lorea Galnares-Cordero

Contact Email: lgalnares@bioef.eus

Copyright: <p>Osteba (Basque Office for Health Technology Assessment) Health Department of the Basque Government</p>