Improving Cervical Cancer Screening Participation Through Human Papillomavirus Self-Sampling: A Scoping Review of Evidence in Underserved Populations
Yao Doe, Noha Aboelata, Mary Alvarez-Nutting, Donald GoldenBackground:
Cervical cancer remains the fourth most common cancer among women worldwide, with an estimated 660,000 new cases and 348,000 deaths in 2022. Despite the demonstrated efficacy of established screening programs, participation remains disproportionately low in underserved populations due to structural, cultural, and personal barriers. Human papillomavirus (HPV) self-sampling has emerged as a promising strategy to improve access to cervical cancer screening for these groups.
Objective:
To map and synthesize evidence on the acceptability and implementation of HPV self-sampling for cervical cancer screening among marginalized populations.
Methods:
A scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines was conducted. PubMed and Embase were searched for literature published between 2002 and 2025. Studies were eligible if they reported acceptability, feasibility, or participant preferences for HPV self-sampling in at least one defined marginalized population. Data were synthesized narratively. Restriction to two databases is acknowledged as a methodological limitation.
Results:
Ten studies spanning eight countries and involving over 6400 participants were included. Acceptance rates ranged from 21% to 98%. Higher acceptance was consistently associated with community-driven implementation models incorporating community health worker involvement, culturally tailored education, and home-visit options. Privacy, autonomy, and convenience were key facilitators; low literacy, fear of results, and health care mistrust were the most common barriers.
Conclusions:
HPV self-sampling can achieve high acceptance in marginalized communities when implemented through culturally sensitive, community-engaged programs with adequate support infrastructure. Integrating education, navigation support, and low-barrier follow-up care offers significant potential for advancing health equity in cervical cancer prevention.