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. 2019 May 14;4(3):e001351. doi: 10.1136/bmjgh-2018-001351

Table 1.

Description of included studies and reported outcomes

Author, year Study location and population characteristics Intervention description Study methods Outcomes
Arrossi et al, 201521 Argentina.
Urban and rural.
Women, general population.
Age: 30+.		 Intervention: self-collected HPV test kit offered by CHW at home visit (collected by CHW).
Cervical specimen, collected at home, unsupervised.
Device: Qiagen test kit (brush).
Control: advice to attend health clinic for cervical screening by CHW at home visit.		 Study design: RCT.
Sample size: 6013 (intervention: 3049; control: 2964).
Length of follow-up: 6 months.
Study name: EMA study.		 Uptake of HPV testing services.
Bais et al, 200722 The Netherlands.
Urban.
Women, non-respondents to regular screening programme.
Age: 30–50.		 Intervention: HPV self-sampling kit directly mailed to home address with prepaid return envelope.
Cervicovaginal specimen, collected at home, unsupervised.
Device: Viba-Brush.
Control: reminder letter for regular cytology screening.		 Study design: RCT.
Sample size: 2636 (intervention: 2352; control: 284).
Length of follow-up: 6 months.		 Uptake of HPV testing services.
Broberg et al, 201423 Sweden.
Urban and rural.
Women, non-respondents to regular screening programme.
Age: 30–62.		 Intervention: HPV self-sampling kit directly mailed to home address with prepaid return envelope.
Cervicovaginal specimen, collected at home, unsupervised.
Device: QvinTip (brush).
Control: screening reminder letter.
Second control: screening reminder letter + telephone call offering appointment for Pap smear.		 Study design: RCT.
Sample size: 8800 (intervention: 800; control: 4000; second control: 4000).
Length of follow-up: 12 months.
Study name: RACOMIP (randomized controlled trial to study methods to increase participation in the cervical cancer screening program).		 Uptake of HPV testing services.
Cadman et al, 201524 England.
Urban and rural.
Women, non-respondents to regular screening programme.
Age: 30–64.		 Intervention: HPV self-sampling kit directly mailed to home address.
Cervicovaginal specimen, collected at home, unsupervised.
Device: Dacron swab.
Control: screening reminder letter (Pap test).		 Study design: RCT.
Sample size: 6000 (intervention: 3000; control: 3000).
Length of follow-up: 3 months.		 Uptake of HPV testing services.
Linkage to clinical assessment or HPV treatment.
Carrasquillo et al, 201825 USA.
Urban and rural.
Women, non-respondents to regular screening programme, ethnic minorities.
Age: 30–65.		 Intervention: HPV self-sampling kit and education offered door-to-door by CHW (return to CHW) or CHW-facilitated navigation to Pap smear.
Cervicovaginal specimen, collected at clinic, supervised.
Device: NR.
Control: CHW outreach and provision of culturally tailored cervical cancer screening information.
Second control: CHW-facilitated navigation to Pap smear.		 Study design: RCT.
Sample size: 601 (intervention: 207; control: 182; second control: 212).
Length of follow-up: 6 months.		 Uptake of HPV testing services.
Castle et al, 201126 USA.
Rural.
Women, non-respondents to regular screening programme, medically underserved, ethnic minorities.
Age: 26–65.		 Intervention: HPV self-sampling kit and education offered door-to-door by study staff (return immediately to staff or mail later).
Cervicovaginal specimen, collected at home, unsupervised.
Device: novel self-sampling kit (brush).
Control: voucher for free Pap test and staff-facilitated appointment at local clinic.		 Study design: prospective cohort.
Sample size: 119 (intervention: 77; control: 42).
Length of follow-up: 1 month.		 Uptake of HPV testing services.
Darlin et al, 201327 Sweden.
Urban and rural.
Women, non-respondents to regular screening programme.
Age: 32–65.		 Intervention: HPV self-sampling kit directly mailed to home address with prepaid preaddressed return envelope.
Vaginal specimen, collected at home, unsupervised.
Device: dry cotton swab.
Control: screened by healthcare provider (Pap test) at an outpatient clinic (flexible, no-fee appointments). A reminder was sent to non-responders.		 Study design: RCT.
Sample size: 1500 (intervention: 1000; control: 500).
Length of follow-up: NR.		 Uptake of HPV testing services.
Duke et al, 201528 Canada.
Rural.
Women, general population.
Age: 30–69.		 Intervention: HPV self-sampling kit available for pick-up at public locations (eg, hospital, pharmacies, hair salons, women‘s exercise centres) or research nurse dropoff at woman’s house or work; return via dropoff at hospital or research nurse pick-up at participant’s convenience) and Pap test and cervical cancer education/promotion campaign.
Cervicovaginal specimen, collected at clinic, supervised.
Device: Dacron swab.
Control: Pap test and regular provincial education campaign.
Second control: Pap test and cervical cancer education/promotion campaign.		 Study design: prospective cohort.
Sample size: 6285 (baseline: intervention: 1928; control: 1524 second control: 2833; endline: intervention: 1760; control: 1536; second control: 2761).
Length of follow-up: 24 months.		 Uptake of HPV testing services.
Giorgi Rossi et al, 201130 Italy.
Urban and rural.
Women, non-respondents to regular screening programme.
Age: 35–65.		 Intervention: HPV self-sampling kit directly mailed to home address with prepaid return envelope.
Cervicovaginal specimen, collected at home, unsupervised.
Device: PantaRhei sampler (lavage).
Second intervention: HPV self-sampling invitation sent by mail (phone order; receive kit by mail or pick up at clinic, prepaid return envelope).
Control: screening reminder letter (Pap test).
Second control: screening reminder letter (HPV test).		 Study design: RCT.
Sample size: 2480 (intervention: 616; second intervention: 622; control: 619; second control: 616).
Length of follow-up: 5 months.		 Uptake of HPV testing services.
Giorgi Rossi et al, 201529 Italy.
Urban and rural.
Women, non-respondents to regular screening programme.
Age: 30–64.		 Intervention: HPV self-sampling kit directly mailed to home address, preceded by a notification.
Cervicovaginal specimen, collected at home, unsupervised.
Device: Delphi Screener (lavage).
Second intervention: HPV self-sampling kit available for pick-up at local pharmacies.
Control: screening reminder letter (Pap test or HPV test).		 Study design: RCT.
Sample size: 14 041 (intervention: 4516; second intervention: 4513; control: 5012).
Length of follow-up: 3 months.		 Uptake of HPV testing services.
Linkage to clinical assessment or HPV treatment.
Gok et al, 201031 The Netherlands.
Urban.
Women, non-respondents to regular screening programme.
Age: 30–60.		 Intervention: HPV self-sampling kit directly mailed to home address, preceded by a notification.
Cervicovaginal specimen, collected at home, unsupervised.
Device: Delphi Screener (lavage).
Control: screening reminder letter (Pap test).		 Study design: RCT.
Sample size: 28 073 (intervention: 27 792; control: 281).
Length of follow-up: 12 months.
Study name: PROHTECT-1 (PRotection by Offering HPV TEsting on Cervicovaginal specimens Trial).		 Uptake of HPV testing services.
Gök et al, 201232 The Netherlands.
Urban.
Women, non-respondents to regular screening programme.
Age: 30–60.		 Intervention: HPV self-sampling kit directly mailed to home address.
Vaginal specimen, collected at home, unsupervised.
Device: Viba-Brush.
Control: screening reminder letter (Pap test).		 Study design: RCT.
Sample size: 26 409 (intervention: 26 145; control: 264).
Length of follow-up: 12 months.
Study name: PROHTECT-2 (PRotection by Offering HPV TEsting on Cervicovaginal specimens Trial).		 Uptake of HPV testing services.
Gustavsson et al, 201833 Sweden.
Urban and rural.
Women, non-respondents to regular screening programme.
Age: 30–49.		 Intervention: HPV self-sampling kit directly mailed to home address with preaddressed return envelope.
Vaginal specimen, collected at home, unsupervised.
Device: Viba-Brush.
Control: screened by healthcare provider (Pap test).		 Study design: RCT.
Sample size: 36 390 (intervention: 17 997; control: 18 393).
Length of follow-up: 18 months.		 Uptake of HPV testing services.
Linkage to clinical assessment or HPV treatment.
Haguenoer et al, 201434 France.
Urban and rural.
Women, non-respondents to regular screening programme.
Age: 30–65.		 Intervention: HPV self-sampling kit directly mailed to home address.
Vaginal specimen, collected at home, unsupervised.
Device: dry nylon flocked swab.
Control: screening reminder letter (Pap test) and phone call reminder.
Second control: no intervention.		 Study design: RCT.
Sample size: 5998 (intervention: 1999; control: 2000; second control: 1999).
Length of follow-up: 12 months.		 Uptake of HPV testing services.
Ivanus et al, 201835 Slovenia.
Urban and rural.
Women, non-respondents to regular screening programme.
Age: 30–64.		 Intervention: HPV self-sampling kit directly mailed to home address.
Cervicovaginal specimen, collected at home, unsupervised.
Device: QvinTip (brush), HerSwab, Delphi Screening (lavage).
Second intervention: HPV self-sampling kit available by order or for pick-up at local pharmacies.
Control: screening reminder letter.		 Study design: RCT.
Sample size: 26 556 (intervention: 9956; second intervention: 14 400; control: 2600).
Length of follow-up: 12 months.		 Uptake of HPV testing services.
Linkage to clinical assessment or HPV treatment.
Kellen et al, 201836 Belgium.
Urban and rural.
Women, non-respondents to regular screening programme.
Age: 30–64.		 Intervention: HPV self-sampling kit directly mailed to home address with prepaid return envelope.
Cervicovaginal specimen, collected at home, unsupervised.
Device: Qvintip (brush).
Second intervention: HPV self-sampling invitation sent by mail; order kit by mail, phone, email or website.
Control: screening reminder letter (Pap test by general practitioner or gynaecologist).
Second control: no intervention.		 Study design: RCT.
Sample size: 35 354 (intervention: 9118; second intervention: 9098; control: 8830; second control: 8849).
Length of follow-up: 12 months.		 Uptake of HPV testing services.
Lam et al, 201737 Denmark.
Urban.
Women, non-respondents to regular screening programme.
Age: 27–65.		 Intervention: HPV self-sampling invitation sent by mail; order kit by mail, phone, email or website; prepaid return envelope.
Cervicovaginal specimen, collected at home, unsupervised.
Device: Evalyn Brush.
Control: screened by healthcare provider (Pap test).		 Study design: cross-sectional.
Sample size: 23 632.
Length of follow-up: 7 months.
Study name: Copenhagen Self-Sampling Initiative.		 Uptake of HPV testing services.
Lazcano-Ponce et al, 201138 Mexico.
Rural.
Women, medically underserved/low socioeconomic status.
Age: 25–65.		 Intervention: HPV self-sampling kit and education offered door-to-door by nurse.
Vaginal specimen, collected at home, supervised.
Device: Digene (brush).
Control: screened by healthcare provider (Pap test).		 Study design: RCT.
Sample size: 25 061 (intervention: 12 330; control: 12 731).
Length of follow-up: NR.
Study name: MARCH (Mexican Appraisal of Routine Cytology versus vaginal HPV screening).		 Uptake of HPV testing services.
Modibbo et al, 201739 Nigeria.
Urban.
Women, general population.
Age: 30–65.		 Intervention: HPV self-sampling kit directly mailed to home address with prepaid return envelope (or could drop off completed kit at designated collection points in community or at the hospital).
Cervicovaginal specimen, collected at home, unsupervised.
Device: NR.
Control: HPV testing appointment at hospital clinic.		 Study design: RCT.
Sample size: 400 (intervention: 200; control: 200).
Length of follow-up: 1 month.		 Uptake of HPV testing services.
Moses et al, 201540 Uganda.
Urban.
Women, general population.
Age: 30–65.		 Intervention: HPV self-sampling kit and education offered door-to-door by outreach worker (return to worker).
Cervicovaginal specimen, collected at home, unsupervised.
Device: Dacron swab.
Control: Screened by healthcare provider (VIA).		 Study design: RCT.
Sample size: 500 (intervention: 250; control: 250).
Length of follow-up: NR.		 Uptake of HPV testing services.
Linkage to clinical assessment or HPV treatment.
Murphy et al, 201641 USA.
Urban.
Women, living with HIV.
Age: 18+.		 Intervention: HPV self-sampling kit offered in HIV clinic.
Cervicovaginal specimen, collected at clinic, unsupervised.
Device: Qiagen test kit (brush).
Control: screening reminder letter.		 Study design: RCT.
Sample size: 94 (intervention: 63; control: 31).
Length of follow-up: 6 months.		 Uptake of HPV testing services.
Piana et al, 201142 France.
Urban.
Women, non-respondents to regular screening programme.
Age: 35–69.		 Intervention: HPV self-sampling kit directly mailed to home address with prepaid preaddressed return envelope, preceded by a notification with an opt-out option.
Cervicovaginal specimen, collected at home, unsupervised.
Device: NR.
Control: screening reminder letter (Pap test).		 Study design: RCT.
Sample size: 9334 (intervention: 4400; control: 4934).
Length of follow-up: 6 months.		 Uptake of HPV testing services.
Racey et al, 201654 Canada.
Rural.
Women, non-respondents to regular screening programme.
Age: 30–70.		 Intervention: HPV self-sampling kit directly mailed to home address with preaddressed return envelope, preceded by a notification with an opt-out option.
Vaginal specimen, collected at home, unsupervised.
Device: Dacron swab.
Control: screening reminder letter (Pap test).
Second control: opportunistic standard-of-care Pap test (no screening reminder).		 Study design: RCT.
Sample size: 818 (intervention: 335; control: 331; second control: 152).
Length of follow-up: NR.		 Uptake of HPV testing services.
Sancho-Garnier et al, 201343 France.
Urban.
Women, non-respondents to regular screening programme, low socioeconomic status.
Age: 35–69.		 Intervention: HPV self-sampling kit directly mailed to home address, preceded by a notification.
Vaginal specimen, collected at home, unsupervised.
Device: Dacron swab.
Control: screened by healthcare provider (Pap smear) at outpatient clinic.		 Study design: RCT.
Sample size: 18 730 (intervention: 8829; control: 9901).
Length of follow-up: NR.		 Uptake of HPV testing services.
Linkage to clinical assessment or HPV treatment.
Sewali et al, 201544 USA.
Urban.
Women, Somali immigrant.
Age: 25–70.		 Intervention: HPV self-sampling kit and education offered door-to-door by outreach worker (return to worker).
Cervicovaginal specimen, collected at home, unsupervised.
Device: Just For Me (brush).
Control: screened by healthcare provider (Pap test).		 Study design: RCT.
Sample size: 63 (intervention: 32; control: 31).
Length of follow-up: 3 months.		 Uptake of HPV testing services.
Sultana et al, 201645 Australia.
Urban and rural.
Women, non-respondents to regular screening programme.
Age: 30–69.		 Intervention: HPV self-sampling kit directly mailed to home address with prepaid return envelope.
Vaginal specimen, collected at home, unsupervised.
Device: NR.
Control: screening reminder letter (Pap test).		 Study design: RCT.
Sample size: 8160 (intervention: 7140; control: 1020).
Length of follow-up: 6 months.
Study name: iPap.		 Uptake of HPV testing services.
Szarewski et al, 201146 England.
Urban.
Women, non-respondents to regular screening programme.
Age: 29–65.		 Intervention: HPV self-sampling kit directly mailed to home address with prepaid preaddressed return envelope.
Cervicovaginal specimen, collected at home, unsupervised.
Device: Qiagen test kit (cotton swab).
Control: screened by healthcare provider (Pap test).		 Study design: RCT.
Sample size: 3000 (intervention: 1500; control: 1500).
Length of follow-up: 6 months.		 Uptake of HPV testing services.
Tranberg et al, 201847 Denmark.
Urban and rural.
Women, non-respondents to regular screening programme.
Age: 30–64.		 Intervention: HPV self-sampling kit directly mailed to home address.
Cervicovaginal specimen, collected at home, unsupervised.
Device: Evalyn Brush.
Second intervention: HPV self-sampling invitation sent by mail; order kit by email, text message, phone or website.
Control: screening reminder letter (Pap test).		 Study design: RCT.
Sample size: 9791 (intervention: 3265; second intervention: 3264; control: 3262).
Length of follow-up: 6 months.
Study name: CHOiCE (Cervical Home-based CancEr screening).		 Uptake of HPV testing services.
Tranberg et al, 201848 Denmark.
Urban and rural.
Women, non-respondents to regular screening programme.
Age: 30–64.		 Intervention: HPV self-sampling kit directly mailed to home address.
Cervicovaginal specimen, collected at home, unsupervised.
Device: Evalyn Brush.
Second intervention: HPV self-sampling invitation sent by mail; order kit by email, text message, phone or website.
Control: screening reminder letter (Pap test).		 Study design: RCT.
Sample size: 9791 (intervention: 3265; second intervention: 3264; control: 3262).
Length of follow-up: 6 months.
Study name: subanalysis of CHOiCE above.		 Uptake of HPV testing services.
Virtanen et al, 201150 Finland.
Urban.
Women, non-respondents to regular screening programme.
Age: 30–60.		 Intervention: HPV self-sampling kit directly mailed to home address.
Cervicovaginal specimen, collected at home, unsupervised.
Device: Delphi Screener (lavage).
Control: screening reminder letter.		 Study design: RCT.
Sample size: 25 597 (intervention: 7086; control: 18 511).
Length of follow-up: NR.		 Uptake of HPV testing services.
Virtanen et al, 201549 Finland.
Urban and rural.
Women, non-respondents to regular screening programme.
Age: 30–60.		 Intervention: HPV self-sampling kit directly mailed to home address.
Cervicovaginal specimen, collected at home, unsupervised.
Device: Delphi Screener (lavage).
Control: screening reminder letter.
Second control: screening reminder letter + second reminder letter.		 Study design: prospective cohort.
Sample size: 30 827 (baseline/control: 30 827; timepoint 2/second control: 7397; timepoint 3/intervention: 4536).
Length of follow-up: 24 months.		 Uptake of HPV testing services.
Viviano et al, 201751 Switzerland.
Urban.
Women, non-respondents to regular screening programme.
Age: 25–69.		 Intervention: HPV self-sampling kit directly mailed to home address with prepaid return envelope.
Cervicovaginal specimen, collected at home, unsupervised.
Device: ESwab.
Control: screened by healthcare provider (liquid-based cytology).		 Study design: RCT.
Sample size: 667 (intervention: 336; control: 331).
Length of follow-up: NR.		 Uptake of HPV testing services.
Linkage to clinical assessment or HPV treatment.
Wikström et al, 201152 Sweden.
Urban.
Women, non-respondents to regular screening programme.
Age: 39–60.		 Intervention: HPV self-sampling kit directly mailed to home address with prepaid return envelope.
Vaginal specimen, collected at home, unsupervised.
Device: Qvintip (brush).
Control: screening reminder letter (Pap test).		 Study design: RCT.
Sample size: 4060 (intervention: 2000; control: 2060).
Length of follow-up: 36 months.		 Uptake of HPV testing services.
Zehbe et al, 201653 Canada.
Rural.
Women, First Nations communities.
Age: 25–69.		 Intervention: HPV self-sampling kit directly mailed to home address.
Cervicovaginal specimen, collected at home, unsupervised.
Device: NR.
Control: screened by healthcare provider (Pap test).		 Study design: RCT.
Sample size: 834 (intervention: 404; control: 430).
Length of follow-up: 3 months
Study name: ACCSS (Anishinaabek Cervical Cancer Screening Study).		 Uptake of HPV testing services.

CHW, community health worker; HPV, human papillomavirus; NR, not reported; RCT, randomised controlled trial; VIA, visual inspection with acetic acid.