Should the HPV self-sampling be promoted in Hong Kong?

Abstract

Routine cervical screening, together with the Human Papillomavirus (HPV) vaccination, has been proven to prevent cervical cancer effectively. Screening adherence therefore is an essential global strategy for cervical cancer elimination worldwide. In the last decade, the implementation of high-risk HPV testing with the option of self-sampling for primary screening at the national level has evolved as a key direction to increase participation in screening and eliminate cervical cancer. It provides screening alternatives for women and reduces healthcare disparities among the vulnerable population. It could be a more cost-effective strategy for strengthening the healthcare systems.

In Hong Kong, the local government has launched a territory-wide Cervical Screening Programmes for two decades to encourage women to have regular cervical screening. The rewards are the decreasing trends in the incidence and mortality of cervical cancer with an increasing coverage rate of screening. However, the latest figures revealed that only one-third of the eligible women had cervical screening within 3 years. The regular cervical screening remains a significant public health concern. Local studies suggested that HPV self-sampling is a feasible and acceptable way to increase screening coverage among the local population, especially for those under-screen women and minority groups. The COVID-19 pandemic has disrupted routine healthcare services, including cervical cancer screening. HPV self-sampling therefore also offers an alternative during times of restricted clinic access. Lessons learned from pandemic adaptations can also inform the importance of the integration of HPV self-sampling into routine cervical screening while increasing awareness, education and clear guidelines are essential for further successful implementation.