Is an HPV Self-Swab as Accurate as a Smear?What Studies Show

More cervical screening now tests for HPV, and France, for example, recommends HPV screening from age 30 to 65.¹ That opens a door: a sample for an HPV test can be collected with a swab you use yourself, without a speculum. The questions are whether it’s accurate, and whether it gets more women screened.

Is a self-swab accurate?

France’s national health authority commissioned reviews of the evidence before updating its screening advice.¹ They found:¹

• With validated lab tests (the PCR type), a self-sample is as sensitive as one taken by a clinician, meaning it’s as good at catching women who need follow-up.
• It’s slightly less specific, meaning a few more women may be called back who turn out to be fine.
• Self-sampling reached under-screened women better than inviting them to book a clinician test.

The authority recommended offering self-sampling to under-screened women aged 30 and over.¹

Does it get more women screened?

Two studies led by London researchers tested it with women at least 6 months overdue for screening.

YouScreen. At GP practices in England, kits were offered in person when overdue women came in for any reason, or posted to them.²

How the kit was offered	Returned a sample
In person, and accepted	65.5%2
Posted	12.9%2

More than 8,300 women screened this way, and they reflected the area’s ethnically diverse and less well-off population.² Overdue women screened per month rose by about 22%.²

A randomized trial. Among overdue and never-screened women:³

Offer	Returned a sample
No offer	1.7%3
Letter inviting them to order a kit	4.8%3
Kit sent in the post	12.3%3

When a GP offered a kit in person, half returned it.³ The results suggest these were mostly women who wouldn’t otherwise have been screened.³

What this means for you

• If the speculum has kept you away, ask whether a self-swab is offered where you live. Rules on who can use one, and whether at home or in a clinic, differ between countries and programs. See three checks before choosing HPV self-collection.
• If a result comes back positive, see four questions after a positive HPV test.
• Screening is for people without symptoms. Bleeding after sex, between periods or after menopause needs a prompt check instead.

Try: “I’ve avoided my smear for years because the exam is hard for me. Is an HPV self-swab an option, and what happens if it comes back positive?”

Down There, Decoded covers this in Chapter 3, “Too Embarrassed to Look,” in a section called “What to Say When You’re Embarrassed,” with opening lines that make a hard appointment easier to start. Its Down-There Log keeps dates and changes in one place, so you arrive with the facts written down. See the book.