Self-collection vs clinician Pap tests
A new meta-analysis compared patient-collected versus clinician-collected cervical cytology for CIN detection, offering evidence on more accessible screening options. The study’s findings feed the push for self-collection strategies in diverse settings. (x.com)
AJOG Global Reports published a systematic review and meta-analysis titled “Patient vs. clinician‑collected cervical cytology for screening for CIN” (Marchand et al.) in its November 2025 issue (DOI 10.1016/j.xagr.2025.100575). (sciencedirect.com) The review included five primary studies and used cervical biopsy histopathology as the reference standard for CIN detection. (peeref.com) Pooled diagnostic performance for patient‑collected cytology was sensitivity 0.698 and specificity 0.805, while clinician‑collected cytology showed higher sensitivity but lower specificity in the same pooled comparisons. (peeref.com) Authors report marked heterogeneity driven by the type of self‑collection device and sampling method across the included studies, with device-specific performance cited as a major source of variability. (peeref.com) The paper notes clinical workflow consequences because self‑collected samples are vaginal rather than endocervical, meaning HPV‑positive self‑samples typically require a follow‑up speculum exam while clinician‑collected specimens can support reflex cytology or dual‑stain from the same sample. (asccp.org) Regulatory and guideline context cited alongside the study: FDA approval for clinic‑based HPV self‑collection was granted in May 2024 and subsequent consensus guidance has been released to operationalize self‑collection into screening programs. (diagnostics.roche.com) Quality‑assurance data from large datasets indicate both clinician‑ and self‑collected HPV specimens can meet cellularity adequacy metrics and that internal control Ct thresholds (e.g., Ct <26 optimal, <28 minimum for the BD Onclarity assay) have been proposed for program‑level QA. (read.qxmd.com)
