HPV self-sampling versus healthcare provider collection on the effect of cervical cancer screening uptake and costs in LMIC: a systematic review and meta-analysis

Author:

Mekuria Selamawit F.ORCID,Timmermans Sydney,Borgfeldt Christer,Jerkeman Mats,Johansson Pia,Linde Ditte Søndergaard

Abstract

Abstract Background Cervical cancer is a major global health issue, with 89% of cases occurring in low- and middle-income countries (LMICs). Human papillomavirus (HPV) self-sampling tests have been suggested as an innovative way to improve cervical cancer screening uptake and reduce the burden of disease. The objective of this review was to examine the effect of HPV self-sampling on screening uptake compared to any healthcare provider sampling in LMICs. The secondary objective was to estimate the associated costs of the various screening methods. Method Studies were retrieved from PubMed, Embase, CINAHL, CENTRAL (by Cochrane), Web of Science, and ClinicalTrials.gov up until April 14, 2022, and a total of six trials were included in the review. Meta-analyses were performed mainly using the inverse variance method, by pooling effect estimates of the proportion of women who accepted the screening method offered. Subgroup analyses were done comparing low- and middle-income countries, as well as low- and high-risk bias studies. Heterogeneity of the data was assessed using I2. Cost data was collected for analysis from articles and correspondence with authors. Results We found a small but significant difference in screening uptake in our primary analysis: RR 1.11 (95% CI: 1.10–1.11; I2 = 97%; 6 trials; 29,018 participants). Our sensitivity analysis, which excluded one trial that measured screening uptake differently than the other trials, resulted in a clearer effect in screening uptake: RR: 1.82 (95% CI: 1.67–1.99; I2 = 42%; 5 trials; 9590 participants). Two trials reported costs; thus, it was not possible to make a direct comparison of costs. One found self-sampling more cost-effective than the provider-required visual inspection with acetic acid method, despite the test and running costs being higher for HPV self-sampling. Conclusion Our review indicates that self-sampling improves screening uptake, particularly in low-income countries; however, to this date, there remain few trials and associated cost data. We recommend further studies with proper cost data be conducted to guide the incorporation of HPV self-sampling into national cervical cancer screening guidelines in low- and middle-income countries. Systematic review registration PROSPERO CRD42020218504.

Funder

ALF grant - an agreement between the county councils and Swedish state.

Lund University

Publisher

Springer Science and Business Media LLC

Subject

Medicine (miscellaneous)

Reference33 articles.

1. World health organisation. WHO guidelines for screening and treatment of precancerous lesions for cervical cancer prevention. Geneva; 2022 http://www.who.int/mediacentre/factsheets/fs380/en/. Accessed Feb 2022.

2. Tsu VD, Levin CE. Making the case for cervical cancer prevention: what about equity? Reprod Health Matters. 2008;16(32):104–12.

3. Beaulieu N BD, Bloom R, Stein R. Breakaway: the global burden of cancer-challenges and opportunities. The Economist intelligience unit. 2009.

4. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209–49.

5. John R RH. The global economic cost of cancer. The American cancer society. 2010. http://phrma-docs.phrma.org/sites/default/files/pdf/08-17-2010_economic_impact_study.pdf. Accessed Feb 2020.

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