Scaling HPV Self-Sampling in Low-Resource Settings: From Evidence to Sustainable Implementation.
4 affiliations
- 1MSF Foundation, Paris, France.
- 2Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO)- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet De Llobregat, Barcelona, Spain.
- 3Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP CB06/02/0073), Madrid, Spain.
- 4Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.
Abstract
Profound global inequities in cervical cancer burden persist, with nearly 90% of deaths occurring in low- and middle-income countries (LMICs). High-performance human papillomavirus (HPV) testing is the recommended primary screening method, but its scale-up remains constrained by resource and infrastructure limitations. HPV self-sampling optimizes health system resources by eliminating universal speculum examinations during primary screening, yet a critical implementation gap remains regarding how programs transition from pilot projects to routine national practice. To examine this transition, a literature search was conducted through May 2026, focusing on implementation of cervical screening using vaginal self-sampling and molecular DNA amplification techniques within resource-limited settings. While policy endorsement in LMICs expanded from 10 countries in 2020 to 29 in 2026-with 23 recommending self-sampling for all women-real-world implementation lags significantly, as reflected in an estimated five-year HPV-based screening coverage of only 2% in LMICs in 2022. Selected country case studies illustrate diverse delivery models and varying stages of implementation scale, ranging from localized research projects and regional campaigns to scaled national programs: community health worker home visits increased screening uptake four-fold in Argentina, digital health platforms and electronic registries are supporting national scale-up in Malaysia and Rwanda, and single-day near-point-of-care projects achieved very high follow-up rates in remote Amazonian populations. Beyond these country experiences, the review evaluates key considerations along the clinical care cascade, highlighting the importance of triage and treatment capacity, active tracing strategies to minimize loss to follow-up, and supply chain management. Ultimately, self-sampling serves as a promising equity strategy whose success relies on sustained political, financial, and structural commitment across the full clinical pathway.
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BibTeX
@article{inturrisi2026scaling,
title = {{Scaling HPV Self-Sampling in Low-Resource Settings: From Evidence to Sustainable Implementation.}},
author = {Federica Inturrisi and Beatriz Serrano and Silvia de Sanjosé},
journal = {International journal of women's health},
year = {2026},
month = oct,
doi = {10.2147/ijwh.s633156},
url = {https://europepmc.org/article/MED/42898094},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Scaling HPV Self-Sampling in Low-Resource Settings: From Evidence to Sustainable Implementation.
AU - Federica Inturrisi
AU - Beatriz Serrano
AU - Silvia de Sanjosé
PY - 2026
DA - 2026/10/12
JO - International journal of women's health
DO - 10.2147/ijwh.s633156
UR - https://europepmc.org/article/MED/42898094
AB - Profound global inequities in cervical cancer burden persist, with nearly 90% of deaths occurring in low- and middle-income countries (LMICs). High-performance human papillomavirus (HPV) testing is the recommended primary screening method, but its scale-up remains constrained by resource and infrastructure limitations. HPV self-sampling optimizes health system resources by eliminating universal speculum examinations during primary screening, yet a critical implementation gap remains regarding how programs transition from pilot projects to routine national practice. To examine this transition, a literature search was conducted through May 2026, focusing on implementation of cervical screening using vaginal self-sampling and molecular DNA amplification techniques within resource-limited settings. While policy endorsement in LMICs expanded from 10 countries in 2020 to 29 in 2026-with 23 recommending self-sampling for all women-real-world implementation lags significantly, as reflected in an estimated five-year HPV-based screening coverage of only 2% in LMICs in 2022. Selected country case studies illustrate diverse delivery models and varying stages of implementation scale, ranging from localized research projects and regional campaigns to scaled national programs: community health worker home visits increased screening uptake four-fold in Argentina, digital health platforms and electronic registries are supporting national scale-up in Malaysia and Rwanda, and single-day near-point-of-care projects achieved very high follow-up rates in remote Amazonian populations. Beyond these country experiences, the review evaluates key considerations along the clinical care cascade, highlighting the importance of triage and treatment capacity, active tracing strategies to minimize loss to follow-up, and supply chain management. Ultimately, self-sampling serves as a promising equity strategy whose success relies on sustained political, financial, and structural commitment across the full clinical pathway.
SN - 1179-1411
ER -