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"Cervical Cancer Screening Using Self-Sampling Kits: A Policy Brief Based on a Narrative Review"
Elahe Haghparast * , Tahere Mazoochi , Tahere Khamechian
, elahe.haghparast77@gmail.com
Abstract:   (5 Views)
Executive Summary
Cervical cancer is highly preventable. However, fewer than 40% of Iranian women have undergone screening. This rate falls far below the World Health Organization (WHO) target of 70%. Additionally, screening coverage varies significantly across provinces. Consequently, late-stage diagnoses and high mortality rates remain common.
Human papillomavirus (HPV) self-sampling offers an alternative solution to close this screening gap. This policy brief draws on a narrative review of PubMed and Google Scholar (2015–January 2026), supplemented by WHO policy documents, focusing on evidence addressing diagnostic accuracy, acceptability, cost-effectiveness, and screening coverage. International evidence shows its diagnostic accuracy is comparable to clinician-collected tests. It also demonstrates high patient acceptability, alongside cost-effectiveness reported in other health-system settings. Self-sampling significantly overcomes cultural and structural barriers and limited healthcare access.
This policy brief evaluates three strategies for integrating self-sampling into Iran’s National Cervical Cancer Screening Program: a targeted approach that distributes kits exclusively in underserved and marginalized regions; an opportunistic approach that offers kits only to women who decline Pap smears or delay screening for over five years; and a universal replacement approach that fully transitions from conventional Pap smears to HPV self-sampling as the primary screening modality.
Assessments suggest that a phased approach (beginning with a combination of targeted and opportunistic approaches and gradually moving toward universal replacement) may offer an appropriate path for health system policymakers in Iran.
Keywords: uterine cervical neoplasms, cervical cancer, self-sampling, Human Papillomavirus
     
Type of Study: Policy Brief | Subject: medicine, paraclinic
Received: 2026/02/16 | Revised: 2026/10/14 | Accepted: 2026/10/14
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