title: The acceptability of self-sampled screening for HPV DNA: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To examine whether or not self-sampled cervical screening for human papillomavirus (HPV) DNA is acceptable and if women prefer self-sampling to clinician-based sampling.
  
  
  METHODS
  Systematic review and meta-analysis.
  
  
  METHODS
  Thirty-seven primary studies obtained through a comprehensive search of six electronic bibliographic databases from 1986 to 2014 and other sources. Search keywords included HPV, screening, DNA testing, vaginal testing, self-collected specimen, self-collected sample, self-sampling, self-screening, preferences and acceptability.
  
  
  METHODS
  Studies eligible for analysis included those that had participants perform self-sampling, evaluated participant acceptance of or preference for self-sampled vaginal HPV DNA and reported data to calculate an effect size. There were no exclusion criteria for publication status or geographical location. Meta-analytic methods were used to quantitatively synthesise effect sizes across studies.
  
  
  RESULTS
  The 37 studies included 18 516 female participants from 24 countries across five continents. Overall, there was a high level of acceptability of self-sampling among the participants. Participants reported preference for self-sampling over clinician sampling due to attractive characteristics such as ease and privacy.
  
  
  CONCLUSIONS
  The overall acceptability of self-sampled cervical screening, coupled with economic and effective care, provides opportunities for expanding screening services. Importantly, this can provide a creative screening alternative for women who do not participate in traditional cytological screening, and may ultimately reduce health disparities and prevent cervical disease.
authors.affiliation: Department of Epidemiology, College for Public Health and Social Justice, St Louis, Missouri, USA.
authors.forename: Erik J
authors.identifier: http://orcid.org/0000-0003-1658-8294
authors.initials: EJ
authors.lastname: Nelson
authors.affiliation: School of Social Work, College for Public Health and Social Justice, St Louis, Missouri, USA.
authors.forename: Brandy R
authors.initials: BR
authors.lastname: Maynard
authors.affiliation: Department of Biostatistics, College for Public Health and Social Justice, St Louis, Missouri, USA.
authors.forename: Travis
authors.initials: T
authors.lastname: Loux
authors.affiliation: Department of Epidemiology, College for Public Health and Social Justice, St Louis, Missouri, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Fatla
authors.affiliation: Department of Epidemiology, College for Public Health and Social Justice, St Louis, Missouri, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Gordon
authors.affiliation: Department of Epidemiology, College for Public Health and Social Justice, St Louis, Missouri, USA.
authors.forename: Lauren D
authors.initials: LD
authors.lastname: Arnold
mesh_terms: D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D006801:Humans; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000517:prevention & control; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D016353:Self-Examination / Q000706:statistics & numerical data; D013048:Specimen Handling; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D014626:Vaginal Smears
keywords: HPV; META-ANALYSIS; SCREENING