HPV-Based Self-Sampling in Cervical Cancer Screening: An Updated Review of the Current Evidence in the Literature
Identifying and reaching women at higher risk for cervical cancer is all-important for achieving the ambitious endpoints set in 2020 by the WHO for global cervical cancer control by 2030. HPV-based (vaginal) self-sampling (SS) represents a cost-effective screening strategy, which has been successful...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-03-01
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| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/15/6/1669 |
| _version_ | 1797613021964533760 |
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| author | Nikoletta Daponte George Valasoulis Georgios Michail Ioulia Magaliou Athina-Ioanna Daponte Antonios Garas Ioanna Grivea Dimitrios P. Bogdanos Alexandros Daponte |
| author_facet | Nikoletta Daponte George Valasoulis Georgios Michail Ioulia Magaliou Athina-Ioanna Daponte Antonios Garas Ioanna Grivea Dimitrios P. Bogdanos Alexandros Daponte |
| author_sort | Nikoletta Daponte |
| collection | DOAJ |
| description | Identifying and reaching women at higher risk for cervical cancer is all-important for achieving the ambitious endpoints set in 2020 by the WHO for global cervical cancer control by 2030. HPV-based (vaginal) self-sampling (SS) represents a cost-effective screening strategy, which has been successfully implemented during the last decade both in affluent and constrained settings. Among other advantages, SS strategies offer convenience, diminished costs, flexibility to obtain a sample in the office or home, avoiding a pelvic exam and uncomfortable appointment with a healthcare professional, as well as social and cultural acceptability. SS implementation has been globally boosted during the COVID-19 pandemic. In pragmatic terms, social distancing, local lockdowns, discontinuation of clinics and reallocation of human and financial resources challenged established clinician-based screening; self-collection strategies apparently surpassed most obstacles, representing a viable and flexible alternative. With time, sufficient reassuring data has accumulated regarding specially designed SS devices, aspects of sample preparation, transport and storage and, importantly, optimization of validated PCR-based HPV testing platforms for self-collected specimens. Suboptimal rates of clinical follow-up post-SS screening, as well as overtreatment with reliance solely on molecular assays, have both been documented and remain concerning. Therefore, effective strategies are still required to ensure linkage to follow-up testing and management following positive SS results by trained health professionals with knowledge of HPV biology and management algorithms. Because of the prolonged SS screening intervals, implementation data are limited regarding subsequent screening rounds of SS-screened individuals; however, these are accumulating gradually. With further refinement of assays and validation of novel biomarkers in self-collected samples, there is a clear potential for increasing SS accuracy and PPV. The potential differentiation of self-collection protocols for vaccinated versus non-vaccinated individuals also represents an open issue. In conclusion, HPV-based self-collection techniques can effectively address limited uptake alongside other conventional cervical screening drawbacks; however, assays, logistics and infrastructures need further optimization to increase the efficacy, effectiveness and cost-effectiveness of SS approaches. |
| first_indexed | 2024-03-11T06:50:05Z |
| format | Article |
| id | doaj.art-e049c3f301b74beb8638aff83eca0df1 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T06:50:05Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-e049c3f301b74beb8638aff83eca0df12023-11-17T10:05:32ZengMDPI AGCancers2072-66942023-03-01156166910.3390/cancers15061669HPV-Based Self-Sampling in Cervical Cancer Screening: An Updated Review of the Current Evidence in the LiteratureNikoletta Daponte0George Valasoulis1Georgios Michail2Ioulia Magaliou3Athina-Ioanna Daponte4Antonios Garas5Ioanna Grivea6Dimitrios P. Bogdanos7Alexandros Daponte8Department of Obstetrics & Gynaecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41500 Larisa, GreeceDepartment of Obstetrics & Gynaecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41500 Larisa, GreeceDepartment of Obstetrics & Gynaecology, Faculty of Medicine, School of Health Sciences, University of Patras, 26504 Patras, GreeceDepartment of Obstetrics & Gynaecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41500 Larisa, GreeceSecond Department of Dermatology-Venereology, Aristotle University School of Medicine, 54124 Thessaloniki, GreeceDepartment of Obstetrics & Gynaecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41500 Larisa, GreeceDepartment of Paediatrics, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41500 Larisa, GreeceDepartment of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41500 Larisa, GreeceDepartment of Obstetrics & Gynaecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41500 Larisa, GreeceIdentifying and reaching women at higher risk for cervical cancer is all-important for achieving the ambitious endpoints set in 2020 by the WHO for global cervical cancer control by 2030. HPV-based (vaginal) self-sampling (SS) represents a cost-effective screening strategy, which has been successfully implemented during the last decade both in affluent and constrained settings. Among other advantages, SS strategies offer convenience, diminished costs, flexibility to obtain a sample in the office or home, avoiding a pelvic exam and uncomfortable appointment with a healthcare professional, as well as social and cultural acceptability. SS implementation has been globally boosted during the COVID-19 pandemic. In pragmatic terms, social distancing, local lockdowns, discontinuation of clinics and reallocation of human and financial resources challenged established clinician-based screening; self-collection strategies apparently surpassed most obstacles, representing a viable and flexible alternative. With time, sufficient reassuring data has accumulated regarding specially designed SS devices, aspects of sample preparation, transport and storage and, importantly, optimization of validated PCR-based HPV testing platforms for self-collected specimens. Suboptimal rates of clinical follow-up post-SS screening, as well as overtreatment with reliance solely on molecular assays, have both been documented and remain concerning. Therefore, effective strategies are still required to ensure linkage to follow-up testing and management following positive SS results by trained health professionals with knowledge of HPV biology and management algorithms. Because of the prolonged SS screening intervals, implementation data are limited regarding subsequent screening rounds of SS-screened individuals; however, these are accumulating gradually. With further refinement of assays and validation of novel biomarkers in self-collected samples, there is a clear potential for increasing SS accuracy and PPV. The potential differentiation of self-collection protocols for vaccinated versus non-vaccinated individuals also represents an open issue. In conclusion, HPV-based self-collection techniques can effectively address limited uptake alongside other conventional cervical screening drawbacks; however, assays, logistics and infrastructures need further optimization to increase the efficacy, effectiveness and cost-effectiveness of SS approaches.https://www.mdpi.com/2072-6694/15/6/1669human papillomavirusHPVself-samplingcervical cancerscreeningsecondary prevention |
| spellingShingle | Nikoletta Daponte George Valasoulis Georgios Michail Ioulia Magaliou Athina-Ioanna Daponte Antonios Garas Ioanna Grivea Dimitrios P. Bogdanos Alexandros Daponte HPV-Based Self-Sampling in Cervical Cancer Screening: An Updated Review of the Current Evidence in the Literature Cancers human papillomavirus HPV self-sampling cervical cancer screening secondary prevention |
| title | HPV-Based Self-Sampling in Cervical Cancer Screening: An Updated Review of the Current Evidence in the Literature |
| title_full | HPV-Based Self-Sampling in Cervical Cancer Screening: An Updated Review of the Current Evidence in the Literature |
| title_fullStr | HPV-Based Self-Sampling in Cervical Cancer Screening: An Updated Review of the Current Evidence in the Literature |
| title_full_unstemmed | HPV-Based Self-Sampling in Cervical Cancer Screening: An Updated Review of the Current Evidence in the Literature |
| title_short | HPV-Based Self-Sampling in Cervical Cancer Screening: An Updated Review of the Current Evidence in the Literature |
| title_sort | hpv based self sampling in cervical cancer screening an updated review of the current evidence in the literature |
| topic | human papillomavirus HPV self-sampling cervical cancer screening secondary prevention |
| url | https://www.mdpi.com/2072-6694/15/6/1669 |
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