By Dr Alice Le Bonniec, Behavioural Insights & Change Specialist, National Screening Service
We’ve published new research about the views and experiences of HPV self-sampling in high income countries. The systematic review of 36 studies examined how women and people with a cervix perceive and experience HPV self-sampling for cervical screening.
Why we did the research
Cervical cancer is one of the most common cancers among women worldwide. Cervical screening helps to prevent cervical cancer developing or to detect it early when it’s easier to treat, reducing deaths.
Self-sampling for the human papillomavirus (HPV) is a newer option that may help more people take part in screening. The aim of the review is to better understand how acceptable and useful HPV self-sampling is.
What we did
We reviewed 36 qualitative studies published between October 2018 and April 2024. All studies were from high-income countries such as the USA, Australia, Ireland and Sweden.
The studies included interviews, focus groups, and surveys with people who had either used HPV self-sampling or had been asked about it. We used a framework to help identify different factors that influence behaviour, such as knowledge, beliefs, emotions and social influences.
What we found
- Knowledge and skills: Many people were not aware of HPV self-sampling or how to do it. Some lacked information about HPV and cervical cancer. Some often wanted clearer instructions and more education about doing the self-test. Some found the self-test easy to do, while others were unsure if they were doing it correctly.
- Beliefs about capabilities and consequences: A common concern among people in the studies was whether they could collect a good enough sample. Some feared hurting themselves or doing it wrong. Others doubted whether self-sampling was as accurate as samples taken by healthcare professionals. Some were unsure why a follow-up test by a doctor might be needed after an HPV-positive result using the self-test.
- Intentions and preferences: Some people said they preferred self-sampling or would be willing to try it, especially if they found going to a GP or clinic difficult. Others still preferred having the test done by a healthcare professional.
- Environmental context and resources: People liked being able to do the test in private, at a time that suited them. They found it more comfortable, less painful, and less embarrassing than going to a GP or clinic. Practical issues like saving time and not needing an appointment were also important. Negative past experiences with traditional cervical screening encouraged interest in self-sampling. Some people who had never attended screening before said self-sampling was the reason they were willing to get tested.
- Social influences and emotions: Support and advice from healthcare professionals and peers influenced many people’s decisions. Emotional barriers such as embarrassment and fear of results were common.
Conclusion
The review found that HPV self-sampling is generally acceptable, especially those who have avoided traditional screening. It may help to increase participation in cervical screening programmes.
Clear, easy-to-understand instructions and information about the reliability of self-sampling is needed. Support from healthcare professionals and different ways to access self-sampling kits, such as by post or in clinics, may help to make self-sampling more accessible.
More research is needed to explore the best ways to deliver and support HPV self-sampling, particularly for groups less likely to attend regular screening.
- Le Bonniec, A., Woods, S., McGlacken, T. et al. What are the views and experiences of human papillomavirus (HPV) self-sampling for cervical screening in high-income countries? A qualitative systematic review using the Theoretical Domains Framework. BMC Public Health (2026). https://doi.org/10.1186/s12889-026-27668-8