A systematic review of self-sampling for HPV testing in Africa

Background Human papillomavirus (HPV) testing may be feasible for primary cervical cancer screening in low-resource countries. Objective To compare self-sampling by women with clinician-performed sampling for HPV testing in Africa. Search strategy MEDLINE, Google scholar, EMBASE, and several journals were searched from 2000 until 2015 using relevant terms. Selection criteria Selected studies compared self-sampled and clinician-sampled HPV tests. Data collection and analysis Data extraction forms included description of the type of HPV screening, description of any additional intervention components, study design, sample size, follow-up periods, analytic approach, reported numerical outcomes, results, and limitations. Results Twenty-five studies were identified. Women of a wide age range were successful at self-sampling in many African countries. More than 95% of self-samples yielded HPV DNA results. The concordance in test results between self-collected samples and clinician-collected samples was reasonably high in most studies. In all studies, the quality of cytology from self-sampling matched that of clinician-sampling. Women were generally positive about self-collection, but noted some concerns. Conclusion Self-sampling for HPV DNA testing seems to represent a feasible alternative to the Pap test. Further research is needed to provide a solid evidence base to inform using of self-sampling for HPV DNA testing for primary cervical cancer screening.