Self-collection for primary HPV screening using dry swabs: a review of clinical performance, laboratory considerations, and patient preferences.

Abstract

For cervical cancer screening, testing for high-risk human papillomavirus (hrHPV) detects more high-grade precancerous lesions, has a higher negative predictive value, and requires fewer lifetime screenings compared to cytology. As a result, both the US Preventive Services Task Force and the World Health Organization have endorsed hrHPV testing as the preferred screening method. Despite the utility, there are significant implementation challenges to adopting hrHPV primary screening across patients, providers, and institutions that must be addressed to ensure its widespread effectiveness. Here, we take a laboratory-centric approach to reviewing hrHPV primary screening, including discussion of specimen types and collection methods. For user experience, clinical and analytical validations, we focused on self-collected vaginal swab specimens stored dry during transport. Our analysis indicates that clinical laboratories should do their part to engage with institutional and clinical leadership to validate and promote the use of vaginal self-sampling for cervical cancer screening options within and outside the clinic. This work highlights the multiple studies that have validated dry swab collection as a simplified and high-quality method for hrHPV detection.