Worldwide Evaluation of Cervical Cancer Self-Sampling Devices

Nearly 90% of cervical cancer and related fatalities occur in low-income and middle-income countries and low-resourced areas within developed countries. In the 1980s, self-sampling was introduced to reach this vulnerable population and those with behavioral aversion to clinician-based screening. Currently, dozens of self-sampling devices have been studied for cervical cancer screening. Here, we consolidated data from an extensive peer-reviewed literature search to summarize the prevalence, accuracy, and acceptance rates of cervical cancer screening self-sampling devices worldwide. We focused, when available, on samples detecting high-risk human papilloma virus (HPV) in cervical intraepithelial neoplasia grade 2 or more. The most studied and commonly accepted devices described in our review include the Evalyn Brush (N=73,986), Delphi Screener (n=28,020), FLOQSwab (N=13,638), Viba-Brush (N=25,565), and Digene Brush (N=12,150). Compared with clinician-based collection, samples derived from self-sampling devices had no significant difference in accurate detection of high-risk HPV. These self-sampling devices have thus been shown to effectively achieve broader global coverage for cervical cancer screening, particularly for limited-access areas. The use of self-sampling devices in populations with low resources and aversion to clinician-based sampling could have a major influence on detection of high-risk HPV and dysplasia, potentially reducing incidence of cervical cancer worldwide.