Comparison and acceptability of HPV self-collected cervical cancer samples versus doctor-collected samples in Africa: a systematic review

Self-collected cervical cancer (CC) samples might be considered alternative strategy and provided an equivalent comparable result on HPV (Human Papillomavirus) detection and acceptability with clinician-collected sampled in Africa. A systematic review was performed using four electronic bibliographic databases (Pubmed, Cochrane, WHO Global health library and Popline) to compared HPV detection rate and acceptability of HPV self-vs clinician collected sampling in Africa. Specific search keywords were used. The study only focused on research articles that compared self-vs clinician-collected samples based on HPV testing and its associated data. Eight research articles and a total of 3476 women were included from six countries in Africa continent. The mean age of women was 40.6 years with range of 16-89 years. Aggregately the high risk (HR)-HPV detection rate was 36% (7.2% -84.8%) and 35% (6.8% - 87.8) of self-vs clinician-collected sampling, respectively. The mean differences and variation in detection rates between sampling methods was 2.6% (SD =1.7). There was significant HR-HPV detection rate correlation between two sampling methods with value of R=0.997. The weighted average of kappa agreement was 0.71(0.47 to 0.89) was moderate. Overall women concluded that self-collected sampling method was a preferred method (86.3%), easy to obtained (77.8%), and 76.7% increased cervical cancer screening uptake. The acceptability of self-collected CC sampled HPV testing could be an alternative sampling method and increased the uptake of screening services. Introducing standardized self-sampling techniques and diagnostic assay study in Africa is paramount.