Introducing self‐sampling for cervical cancer screening: A regional implementation study in Pirkanmaa, Finland

INTRODUCTION: HPV primary testing is the preferred method for cervical cancer screening worldwide and enables vaginal self-sampling at home. Self-sampling performs comparably to clinician-collected samples and can improve participation, especially among non-attenders. In Finland, self-sampling has so far been piloted in the Helsinki region. This study evaluated the feasibility and acceptability of self-sampling in Pirkanmaa, providing a representative model of implementation outside the capital region. MATERIAL AND METHODS: The self-sampling in cervical cancer routine screening (FALCON) study (NCT06931184) targeted women living in Pirkanmaa who did not respond to the initial cervical cancer screening invitation. In a reminder letter, they were offered an opt-in model self-sampling option. Participants ordered a self-sampling kit containing a FLOQSwab (Copan), instructions, and a prepaid return envelope. Samples were analyzed with the Roche Cobas 4800 HPV assay at Fimlab Laboratories. HPV-positive women were referred for cytology testing and managed according to national guidelines. Participants completed two online questionnaires: one at kit order and another 60 days later. RESULTS: Of 16 289 reminder letters, 329 kits were ordered, and 304 (1.9%) samples were returned. Participants (mean age 48 [range 29.9-65.8]) were mostly well-educated with previous screening history. Time-saving, reduced discomfort, and lower embarrassment were the main reasons for choosing home-sampling. HPV was detected in 6.9% of the samples, with one case of histological HSIL identified. Most participants found self-sampling easy and comfortable, and nearly all would recommend it to others. CONCLUSION: Despite the small number of participants in this first year, the study offers early evidence of the strong acceptability and practicality of self-sampling among women in Pirkanmaa, warranting further evaluation at a larger scale.