Table 1 Summary of intervention characteristics

Gizaw et al., 2019 [47]

Ethiopia

Women

Age: 30–49 years

CRCT

1299 (HPV Self-sampling arm:835; VIA arm:464)

Intervention: One arm of the intervention involved self-collection-based HPV DNA testing. Women were offered an Evalyn Brush (Rovers) to collect a swab under active supervision by a trained health professional. Women collected samples in a private area in the health post. Samples were immediately placed in a plastic bag provided by the Evalyn Brush Company after giving a unique ID to the study participants.

Control: The other arm of the study completed VIA at a hospital. A trained and certified the nurse was responsible for performing the screening. All women who tested VIA positive were rescreened by a gynecologist for quality assurance.

Uptake of HPV testing

Of those women who attended the VIA and HPV arms, 40%, and 65.4% adhered to all procedures expected after the screening, respectively. Out of women positive for high-risk HPV, 122 (85%) attended VIA as a follow-up test. The trial demonstrated significantly higher levels of population-based uptake and adherence for self-collection HPV testing.

Huchko et al., 2017 [46]; Oketch et al., 2019 [80]; Page et al., 2019 [81]

Kenya

Women

Age: 25–65 years

CRCT

4944

Intervention: Cervical cancer screening was carried out using HPV testing of self-collected specimens through community health campaigns

Device-careHPV

Control: HPV testing at health facilities

Uptake of HPV testing

Screening uptake was greater in communities assigned to community health campaigns compared to those assigned to receive screening through health facilities (60.0% vs 37.0%, P<0.001).

Modibbo et al., 2017 [48]

Nigeria

Women residing in an urban area Age: 30–65 years

RCT

400 (Intervention group: 200; Control group: 200)

Intervention: HPV self-sampling kit directly mailed to the home address with a prepaid return envelope (or could drop off the completed kit at designated collection points in the community or the hospital). Cervicovaginal specimen, collected at home, unsupervised.

Device: Not reported

Control: HPV testing appointment at the hospital clinic.

Uptake of HPV testing services

Length of follow-up: 1 month

Most participants in the self-collection arm (93%, 185/200) submitted their samples while only 56% (113/200) of those invited to the hospital for sample collection attended and were screened during the study period (p value < 0.001).

Moses et al., 2015 [49];

Mezei et al., 2018 [10]

Uganda

Women residing in an urban area

Age: 30–65 years

RCT

500 (Intervention group:250; Control group: 250)

Intervention: HPV self-sampling kit and education offered door-to-door by outreach worker (return to the worker).

Cervicovaginal specimen, collected at home, unsupervised.

Device: Dacron swab.

Control: Screened by a healthcare provider (VIA)

Uptake of HPV testing services.

Linkage to clinical assessment or HPV treatment

In the HR-HPV arm, 248 of 250 (p < 0.01) women provided samples, while in the VIA arm, 121 of 250 (48.4%) women attended the screening. Among the 73 of 248 HR-HPV-positive women, 45.2% (N = 33) attended VIA screening for follow-up, 21.2% (N = 7) of whom screened positive; five received treatment, and two were missing clinical follow-up records.

Of the 121 women in the VIA arm who attended the screening, 13.2% (N = 16) screened positive; seven received cryotherapy, three refused treatment, five were referred to colposcopy; and one woman had suspected cervical cancer and received treatment after confirmatory testing.

Sossauer et al., 2014 [45]

Cameroon

Women

Age: 25–65 years

RCT

301 (Intervention group:152; Control group: 149)

Intervention: Standard information (this included explanations about what the tests detects (HPV), the link between HPV and cervical cancer, and how to perform HPV self-sampling) followed by the educational intervention (this consisted of a culturally tailored video about HPV, cervical cancer, Self-HPV, and its relevancy as a screening test).

Control: Standard information

Knowledge about HPV and acceptability and confidence in using self-HPV

301 women (149 in the “control group” and 152 in the “intervention group”) completed the full process and were included in the analysis. Participants who received the educational intervention had a significantly higher knowledge about HPV and cervical cancer than the control group (p,0.05), but no significant difference in Self-HPV acceptability and confidence in the method was noticed between the two groups.