HPV Self-Sampling May Improve Cervical Screening Access

HUMAN papillomavirus (HPV) self-sampling could offer a promising approach to improving cervical cancer screening access among socially vulnerable migrant women, according to a mixed-methods study conducted in Portugal.

Researchers found high levels of acceptability among women participating in a community-based HPV self-sampling intervention, with significant improvements in perceived comfort, confidence, and trust following the experience. The findings suggest that culturally adapted screening approaches delivered through trusted community organisations could help address persistent inequalities in cervical cancer prevention.

Addressing Barriers to Cervical Cancer Screening

Cervical cancer is largely preventable through regular screening and timely management of precancerous changes. However, participation in screening programmes remains suboptimal among migrant women and those experiencing social vulnerability.

Barriers to conventional screening can contribute to inequalities in cervical cancer incidence and mortality, highlighting the need for more accessible and culturally appropriate preventive services.

HPV self-sampling allows women to collect their own samples for HPV testing, potentially addressing concerns associated with clinician-collected screening, including discomfort, embarrassment, and privacy.

To investigate its acceptability, researchers conducted a sequential mixed-methods study involving 111 socially vulnerable migrant women aged 30–65 years in Lisbon, Portugal.

Participants took part in a culturally adapted HPV self-sampling intervention delivered through community-based organisations. Researchers used questionnaires before and after the intervention to assess anticipated and experienced acceptability, alongside mini-focus group discussions involving eight participants.

HPV Self-Sampling Improves Confidence and Comfort

The findings demonstrated high perceived acceptability of HPV self-sampling among participants.

Comparisons of responses before and after the intervention identified statistically significant changes in several aspects of the screening experience (p<0.05).

These included improvements in trust in test results, perceived ease and comfort, confidence in performing self-sampling, and perceptions of the time required to complete the process.

Participants also reported reductions in pain, nervousness, embarrassment, and the perceived need for assistance.

The qualitative findings provided further insight into these experiences, with women highlighting privacy, simplicity, and trust as important advantages of self-sampling.

However, some participants expressed concerns about whether they had performed the test correctly and what a positive HPV result might mean.

These findings highlight the importance of clear instructions, accessible information, and appropriate support when introducing self-sampling into cervical cancer screening programmes.

Community-Based Screening Could Reduce Inequalities

The researchers identified trusted community settings as potential facilitators of HPV self-sampling, particularly for women who may experience difficulties accessing conventional healthcare services.

Delivering screening interventions through community-based organisations could provide opportunities to address concerns, offer culturally appropriate guidance, and improve confidence in the screening process.

The findings suggest that acceptability depends not only on the sampling method itself but also on how the intervention is introduced and supported.

Nevertheless, the study assessed perceived acceptability rather than long-term screening participation. Its relatively small sample and the involvement of only eight women in qualitative discussions also limit the generalisability of the findings.

Further research is needed to determine whether positive experiences with HPV self-sampling translate into sustained screening uptake and more equitable participation across different populations and healthcare settings.

The researchers concluded that HPV self-sampling was well accepted among socially vulnerable migrant women and could inform the development of more inclusive cervical cancer screening strategies, particularly when delivered through trusted community organisations.

Reference

Kinaan, W., Gama, A., Marques, P. et al. Human papillomavirus self-sampling for cervical cancer screening in Portugal: a mixed-methods acceptability study among socially vulnerable migrant women. Reprod Health (2026). https://doi.org/10.1186/s12978-026-02460-4