High-risk human papillomavirus (HPV) causes nearly all cases of cervical cancer. However, many invasive cases occur because patients lack adequate screening. Transmasculine and nonbinary individuals face unique healthcare barriers, and as a result, they are frequently underscreened compared to cisgender women. Therefore, HPV self-sampling has emerged as a vital strategy to increase screening uptake in these populations. Specifically, this narrative review assesses the acceptability and efficacy of self-sampling as a primary screening modality.

Benefits of HPV Self-sampling

Research indicates that transmasculine and nonbinary patients find self-sampling highly acceptable. Furthermore, the majority of these individuals prefer collecting their own samples instead of undergoing clinician-collected procedures. Although specific preferences varied across different studies, the ability to choose a method remains critically important. For example, one study demonstrated that offering the option to self-sample significantly increased adherence to screening schedules. Because this method reduces the physical and psychological discomfort of traditional exams, clinicians should feel comfortable offering it to their patients. Moreover, providing such inclusive options helps build trust within marginalized communities.

Clinical Implementation and Future Research

Consequently, healthcare providers should integrate self-testing into routine cervical cancer screening protocols. While clinicians need more research to guide long-term follow-up recommendations, the immediate benefits of increased adherence are clear. Additionally, further studies will help clarify the long-term impact of this modality on cancer incidence rates. Similarly, medical education must focus on preparing providers to discuss these options sensitively. In conclusion, HPV self-sampling represents a significant advancement in patient-centered care and health equity.

Frequently Asked Questions

Is HPV self-sampling as accurate as clinician-collected tests?

Yes, clinical evidence suggests that high-risk HPV DNA testing on self-collected vaginal samples has comparable sensitivity to samples collected by a healthcare provider. Therefore, it is a reliable primary screening option.

Why do transmasculine patients prefer self-sampling?

Many transmasculine individuals experience gender dysphoria or trauma during traditional speculum-based pelvic exams. Self-sampling allows for more privacy and control, which consequently increases comfort and willingness to be screened.

What happens if an HPV self-sampling test is positive?

If a self-collected sample tests positive for high-risk HPV, the patient will typically require follow-up care. This may include a clinician-collected cytology (Pap test) or a colposcopy to evaluate for precancerous lesions.

Disclaimer: This content is for informational and educational purposes only and does not constitute medical advice. Always seek the advice of a qualified healthcare provider with any questions regarding a medical condition. Refer to the latest local and national guidelines for clinical practice.

References

Clark M et al. Self-Sampling for Cervical Cancer Screening in Transmasculine and Nonbinary People. Obstet Gynecol. 2026 Apr 30. doi: 10.1097/AOG.0000000000006296. PMID: 42060925.

World Health Organization. WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention, second edition. Geneva: World Health Organization; 2021.

Reisner SL et al. Test performance and acceptability of self- versus provider-collected swabs for high-risk HPV DNA testing in female-to-male trans masculine patients. PLOS ONE. 2018;13(3):e0190172.