Implementación de la auto-toma para VPH en programas de tamizaje
DOI:
https://doi.org/10.61347/ei.v5iEsp.2.399Palabras clave:
Automuestreo cervicovaginal, cáncer cervicouterino, implementación sanitaria, tamizaje cervical, virus del papiloma humanoResumen
El automuestreo cervicovaginal para la detección del virus del papiloma humano (VPH) constituye una alternativa para fortalecer los programas de tamizaje del cáncer cervicouterino, especialmente en poblaciones con barreras de acceso sanitario. El objetivo fue evaluar la evidencia científica sobre su implementación en programas de tamizaje, considerando las características metodológicas y poblacionales de los estudios, el desempeño diagnóstico, la aceptación y la factibilidad. Se realizó una revisión sistemática conforme a las recomendaciones PRISMA 2020, mediante búsquedas en Scopus y SciELO de publicaciones correspondientes al período 2021–2026. Se incluyeron 36 estudios que examinaron diferentes poblaciones, dispositivos, pruebas moleculares y estrategias de implementación. Los resultados identificaron una aceptación variable entre las usuarias, relacionada con la privacidad, comodidad, autonomía y confianza en el procedimiento. El desempeño diagnóstico presentó diferencias según el dispositivo utilizado, el ensayo molecular y el desenlace evaluado, mientras que la disponibilidad limitada de indicadores comparables restringió las conclusiones sobre su equivalencia con la toma convencional. Las estrategias domiciliarias, comunitarias y de atención primaria mostraron posibilidades de implementación, aunque persistieron barreras educativas, culturales y organizacionales. Se concluyó que el automuestreo cervicovaginal representa una alternativa potencial para complementar los programas de tamizaje del VPH y facilitar el acceso de poblaciones subatendidas. No obstante, su incorporación requiere dispositivos validados, educación sanitaria y seguimiento clínico, así como investigaciones que evalúen su sostenibilidad, costo-efectividad e impacto en la cobertura efectiva.
Descargas
Citas
Aasbø, G., Tropè, A., Nygård, M., Kraus, I., Baasland, I., Iversen, G., … Hansen, B. (2022). HPV self-sampling among long-term non-attenders to cervical cancer screening in Norway: A pragmatic randomised controlled trial. British Journal of Cancer, 127, 1816–1826. https://doi.org/10.1038/s41416-022-01954-9
Adekunle, T., Arreola, A., Sembian, S., Castro, R., Claure, L., Balian, L., & Rodriguez, N. (2023). Feasibility and anticipated acceptability of community health worker-facilitated HPV self-sampling for cervical cancer screening around Lake County, Indiana. Journal of Clinical and Translational Science, 7, e157. https://doi.org/10.1017/cts.2023.578
Akintola, A., Dareng, E. O., Adebamowo, S., & Adebamowo, C. (2026). Impact of educational intervention on the uptake of self-sampling for HPV test-based cervical cancer screening. Frontiers in Oncology, 16, 1810950. https://doi.org/10.3389/fonc.2026.1810950
Anand, K., Mishra, G., Suryawanshi, V., Pimple, S., Kulkarni, V., & Vahabi, M. (2026). Experiences with HPV self-sampling in India: Advancing cervical cancer prevention and screening. BMC Public Health, 26, 999. https://doi.org/10.1186/s12889-026-26212-y
Arbyn, M., Xu, L., Simoens, C., & Martin-Hirsch, P. (2018). Prophylactic vaccination against human papillomaviruses to prevent cervical cancer and its precursors. Cochrane Database of Systematic Reviews, 2018(5), Article CD009069. https://doi.org/10.1002/14651858.CD009069.pub3
Arum, A., Korsgaard, E., Pedersen, H., Dahl, T., Frandsen, P., Tønnes Pedersen, B., … Bonde, J. (2025). Large-scale study comparing analytical and diagnostic quality of three HPV self-sampling devices for at-home cervical cancer screening. APMIS, 133, e70109. https://doi.org/10.1111/apm.70109
Asare, M., Ebu, N., Sencherey, V., Lamptey-Mills, E., Ken-Amoah, S., Akakpo, P., Sturdivant, R., & Obiri-Yeboah, D. (2025). Culturally adapting and evaluating an evidence-based communication intervention with HPV self-sampling to improve cervical cancer screening among women living with HIV in Ghana: A mixed-methods study. BMJ Open, 15, e105852. https://doi.org/10.1136/bmjopen-2025-105852
Besó, M., Ibañez, J., Castan, S., Mira, J., Guilabert, M., Vanaclocha, M., … Molina-Barceló, A. (2025). Optimisation of a cervical cancer screening model based on self-sampling for human papillomavirus testing. Cancer Control, 32, 1–12. https://doi.org/10.1177/10732748251378812
Bokan, T., Ivanus, U., Jerman, T., Takac, I., & Arko, D. (2021). Long term results of follow-up after HPV self-sampling with devices Qvintip and HerSwab in women non-attending cervical screening programme. Radiology and Oncology, 55(2), 187–195. https://doi.org/10.2478/raon-2021-0001
Bonney, E., Gyekye, E., Klutse, J., Attoh, D., Tay, Y., Thomford, N., … Ahorlu, C. (2025). Barriers and facilitators of integrating cervical cancer screening into routine HIV care and acceptability of self-sampling for HPV DNA testing among people with HIV: An exploratory study in southern Ghana. Frontiers in Public Health, 13, 1679325. https://doi.org/10.3389/fpubh.2025.1679325
Bula, A., Mhango, P., Tsidya, M., Chimwaza, W., Kaira, P., Ghambi, K., … Chipeta, E. (2025). Client perspectives and satisfaction with integrating facility and community-based HPV self-sampling for cervical cancer screening with family planning: A mixed method study. BMC Public Health, 25, 1718. https://doi.org/10.1186/s12889-025-22761-w
Cabrera, S., Linares, A., Martínez Meléndez, J., & Abullarade, E. (2022). Autotoma para detección de VPH comparada con muestra convencional en el tamizaje de cáncer cervicouterino. Alerta, Revista Científica del Instituto Nacional de Salud, 5(1), 81–87. https://doi.org/10.5377/alerta.v5i1.12806
Chacón, J., Mateos, M., Sanz, I., Rubio, M., & Baquero, F. (2006). Genotipos de virus del papiloma humano más frecuentes en mujeres con citología cervicovaginal alterada utilizando técnicas de captura de híbridos y reacción en cadena de la polimerasa. Clínica e Investigación en Ginecología y Obstetricia. https://n9.cl/bgkkm
de Martel, C., Georges, D., Bray, F., Ferlay, J., & Clifford, G. M. (2020). Global burden of cancer attributable to infections in 2018: a worldwide incidence analysis. The Lancet Global Health, 8(2), e180–e190. https://doi.org/10.1016/S2214-109X(19)30488-7
Ding, N., Chen, Y., Zhou, X., Wang, G., Li, J., & Wang, X. (2026). Women’s preferences for HPV self-sampling in cervical cancer screening: A discrete choice experiment. Frontiers in Public Health, 14, 1779443. https://doi.org/10.3389/fpubh.2026.1779443
Dzobo, M., Dzinamarira, T., Murewanhema, G., Chishapira, T., Dube Mandishora, R., Fitzpatrick, M., & Mashamba-Thompson, T. (2023). Co-creation of human papillomavirus self-sampling delivery strategies for cervical cancer screening in rural Zimbabwe: Nominal group technique. Frontiers in Public Health, 11, 1275311. https://doi.org/10.3389/fpubh.2023.1275311
Elfström, K., Hortlund, M., Öhman, D., & Dillner, J. (2026). Cancer detection using human papillomavirus self-sampling targeting long-term non-attenders in an organized cervical screening program. International Journal of Cancer, 158(10), 2729–2735. https://doi.org/10.1002/ijc.70321
Fonseca, C. (2022). Autotoma de células cervicales con identificación del DNA del virus del papiloma humano, una alternativa en la política pública de tamización de cáncer de cérvix para poblaciones rurales en Colombia. Ciencia Latina Revista Científica Multidisciplinar, 6(3), 1157–1167. https://doi.org/10.37811/cl_rcm.v6i3.2280
Gamelin, R., Hébert, M., Tratt, E., & Brassard, P. (2022). Ethnographic study of the barriers and facilitators to implementing human papillomavirus (HPV) self-sampling as a primary screening strategy for cervical cancer among Inuit women of Nunavik, Northern Quebec. International Journal of Circumpolar Health, 81(1), 2032930. https://doi.org/10.1080/22423982.2022.2032930
Goff, J., Duc-Banaszuk, A., Lefeuvre, C., Pivert, A., Ducancelle, A., De Pauw, H., Arbyn, M., Vinay, A., & Rexand-Galais, F. (2023). Acceptability to healthcare professionals of home-based HPV self-sampling for cervical screening: A French qualitative study conducted in an area with low access to health services. Cancers, 15(21), 5163. https://doi.org/10.3390/cancers15215163
Hald, S., Tatari, C., Kirkegaard, P., Tranberg, M., Andersen, B., & Nielsen, C. (2025). “Well, that was pretty clever!”—Ethnic minority women’s views on HPV self-sampling devices for cervical cancer screening: Attitudes to brushes, first-void urine, and menstrual blood devices. Journal of Racial and Ethnic Health Disparities, 12, 1304–1314. https://doi.org/10.1007/s40615-024-01963-9
Ji, X., Hao, M., Wang, Y., Pan, Z., Yang, R., Wang, X., Wang, H., … Miao, J. (2024). HPV self-sampling for cervical cancer screening in China: A multi-center study. Heliyon, 10, e39544. https://doi.org/10.1016/j.heliyon.2024.e39544
Kero, K., & Rautava, J. (2019). HPV infections in heterosexual couples: Mechanisms and covariates of virus transmission. Acta Cytologica, 63(2), 143–147. https://doi.org/10.1159/000494710
Lurgain, J., Peremiquel-Trillas, P., Ouaarab-Essadek, H., Mellouki, K., Malik-Hameed, S., Sarif, A., … Gilham, C. (2025). Moroccan and Pakistani women’s knowledge and perceptions on cervical cancer screening and HPV self-sampling acceptability in Catalonia, Spain: A mixed-methods study. BMC Health Services Research, 25, 1502. https://doi.org/10.1186/s12913-025-13488-w
Mathews, C., Sargent, A., Cuschieri, K., Rebolj, M., Brentnall, A. R., Mackie, A., … Denton, K. (2025). HPValidate—Human papillomavirus testing with DNA and mRNA assays on self-collected samples in cervical screening: Comparison of test characteristics on three self-sampling devices. British Journal of Cancer, 133, 665–673. https://doi.org/10.1038/s41416-025-03102-5
Medina, M., Marinic, K., Medina, M., Sorrentino, A., Giménez, M., & Merino, L. (2021). Detección de papilomavirus humano en mucosa oral en hombres con verrugas anogenitales. Memorias del Instituto de Investigaciones en Ciencias de la Salud, 19(2), 41–48. https://doi.org/10.18004/MEM.IICS/1812-9528/2021.019.02.41
Mhango, P., Kumitawa, A., Malata, M. P., Tang, J. H., Chipeta, E., Kandeya, B., … Mwapasa, V. (2025). Acceptability, feasibility and appropriateness of integrating HPV self-sampling for cervical cancer screening into voluntary family planning services in Malawi. BMC Public Health, 25, 2615. https://doi.org/10.1186/s12889-025-23822-w
Mora, M., De La Cuadra, B., Boconzaca, E., Montesdeoca, M., Rodríguez, C., Villamar, G., & Calderón, M. (2025). Diagnóstico y tratamiento avanzado del cáncer de cérvix. Revista Ecuatoriana de Ciencia, Tecnología e Innovación en Salud Pública, 9(28), 53–63. https://doi.org/10.31790/inspilip.v9i27.718
Moukam, A., Salah, N., Tankeu, G., Djommo, L., Lemoupa, S., Wisniak, A., Sormani, J., Kenfack, B., Vassilakos, P., Socpa, A., Petignat, P., & Schmidt, N. (2025). Acceptability of home-based HPV self-sampling for cervical cancer screening among users and providers in the West region of Cameroon: A cross-sectional study. BMC Health Services Research, 25, 1303. https://doi.org/10.1186/s12913-025-13467-1
Ng, X., Quek, I., Pereira, M., Molina, J., Tan, K., Ngeow, J., & Wong, S. (2026). Effect of self-sampling HPV DNA testing on cervical cancer screening in Singapore’s primary care: Pragmatic randomized controlled trial. Annals of Family Medicine, 24, 291–300. https://doi.org/10.1370/afm.250683
Ngu, S. F., Lau, L., Li, J., Wong, G. Y., Cheung, A., Ngan, H., & Chan, K. (2022). Human papillomavirus self-sampling for primary cervical cancer screening in under-screened women in Hong Kong during the COVID-19 pandemic. International Journal of Environmental Research and Public Health, 19, 2610. https://doi.org/10.3390/ijerph19052610
Nyabigambo, A., Mayega, R., Hlongwana, K., & Ginindza, T. (2023). Facilitators and barriers to HPV self-sampling as a cervical cancer screening option among women living with HIV in rural Uganda. International Journal of Environmental Research and Public Health, 20(11), 6004. https://doi.org/10.3390/ijerph20116004
Organización Mundial de la Salud. (2024, 5 de marzo). Papilomavirus humano y cáncer. https://www.who.int/es/news-room/fact-sheets/detail/human-papilloma-virus-and-cancer
Ortiz, V., Ricardo, A., Barrera, R., Barrera, F., & Pacheco, P. (2025). Detección temprana y la tasa de diagnóstico de cáncer de cuello uterino: Revisión de literatura. Ciencia Latina Revista Científica Multidisciplinar, 9(5), 9683–9710. https://doi.org/10.37811/cl_rcm.v9i5.20290
Peremiquel-Trillas, P., Roura, E., Rangel-Sarmiento, V., Morey, F., Font, R., Carvajal, M., … Bruni, L. (2025). Building the foundations for an organized population-based cervical cancer screening program with primary HPV self-sampling in Catalonia, Spain: Findings from a pilot implementation study. Frontiers in Medicine, 12, 1580665. https://doi.org/10.3389/fmed.2025.1580665
Phung, M., Le, P., Khoja, L., Lee, A. W., & Pearce, C. (2025). Southern Vietnamese women’s views on HPV vaccination, cervical cancer screening, and HPV self-sampling. Scientific Reports, 15, 30928. https://doi.org/10.1038/s41598-025-16248-2
Pourette, D., Cripps, A., Guerrien, M., Desprès, C., Opigez, E., Bardou, M., & Dumont, A. (2022). Assessing the acceptability of home-based HPV self-sampling: A qualitative study on cervical cancer screening conducted in Reunion Island prior to the RESISTE trial. Cancers, 14(6), 1380. https://doi.org/10.3390/cancers14061380
Pratt, R., Barsness, C., Lin, J., Adan, F., Abdi, S., Mohamed, S., … Winer, R. (2026). Experience with cervical cancer screening and views on HPV self-sampling among Somali American women. Journal of General Internal Medicine, 41, 2154–2164. https://doi.org/10.1007/s11606-025-10080-0
Rakhmanova, M., Sakko, Y., Suleimenova, A., Sakhipova, G., Marat, A., & Aimagambetova, G. (2026). Patient acceptance of HPV self-sampling approach for cervical cancer screening: Evidence from a pilot study in Kazakhstan. Annals of Medicine, 58(1), 2645175. https://doi.org/10.1080/07853890.2026.2645175
Reyes-Alvarado, A., Chumbe-Perlacios, D., Lozano-Ocampo, L., Vela-Ruiz, J., & Alatrista, M. (2026). Revisión sistemática de normativas en la prevención del cáncer de cérvix en Latinoamérica: Implicancias para la gestión sanitaria. Revista de Obstetricia y Ginecología de Venezuela, 86(1), 112–124. https://doi.org/10.51288/00860114
Sahlgren, H., Sparén, P., Elfgren, K., & Elfström, K. (2022). Feasibility of sending a direct send HPV self-sampling kit to long-term non-attenders in an organized cervical screening program. European Journal of Obstetrics & Gynecology and Reproductive Biology, 268, 68–73. https://doi.org/10.1016/j.ejogrb.2021.11.430
Singh, N., Mangal, S., Tanwar, P., Singhal, S., Yadav, A., & Mathur, S. (2025). Evaluating the feasibility and acceptability of cervical cancer screening in an urban slum community by HPV self-sampling with the aid of telecounselling: Lessons learnt. Asian Pacific Journal of Cancer Prevention, 26(12), 4331–4338. https://doi.org/10.31557/APJCP.2025.26.12.4331
Su, P., Ma, J., Yu, L., Tang, S., & Sun, P. (2023). Clinical significance of extended high-risk human papillomavirus genotyping and viral load in cervical cancer and precancerous lesions. Gynecology and Obstetrics Clinical Medicine, 3(1), 22–29. https://doi.org/10.1016/j.gocm.2023.01.001
Sultana, F., Gertig, D., English, D., Simpson, J., Drennan, K., Wrede, C., … Brotherton, J. (2022). HPV self-sampling and follow-up over two rounds of cervical screening in Australia – the iPap trial. Journal of Medical Screening, 29(3), 185–193. https://doi.org/10.1177/09691413221080635
Veerus, P., Hallik, R., Jänes, J., Jõers, K., Paapsi, K., Laidra, K., & Innos, K. (2022). Human papillomavirus self-sampling for long-term non-attenders in cervical cancer screening: A randomised feasibility study in Estonia. Journal of Medical Screening, 29(1), 53–60. https://doi.org/10.1177/09691413211052499
Vijayan, A., Muthukrishnan, A., Nair, A., Fathima, S., Nair, P., & Roshan, J. (2022). PCR-based evaluation of human papillomavirus genotypes in oral lichen planus. Journal of Pharmacy & Bioallied Sciences, 14(Suppl. 1), S449. https://doi.org/10.4103/jpbs.jpbs_147_22
Villa-Feijoó, A. (2022). Estrategias de promoción de la salud y prevención de enfermedades desde la perspectiva de la enfermería en Ecuador. Revista Científica Zambos, 1(3), 1–14. https://doi.org/10.69484/rcz/v1/n3/29
Villena, R. (2020). Las vacunas como estrategias de erradicación y prevención … cuánto nos han ayudado y cuánto las estamos aprendiendo a valorar nuevamente. Revista Médica Clínica Las Condes, 31(3), 221. https://doi.org/10.1016/j.rmclc.2020.07.005
Vink, E., Antaya, G., Hamula, C., Holinaty, C., Minion, J., Pond, G. R., … Brown Broderick, J. (2024). HPV self-sampling for cervical cancer screening in under-screened Saskatchewan populations: A pilot study. Current Oncology, 31, 4261–4269. https://doi.org/10.3390/curroncol31080317
White, C., & McGregor, L. (2026). ‘…but look how many lives would have been saved if this was available then’ Exploring the acceptability of future Human Papillomavirus self-sampling, and the barriers and facilitators of cervical cancer screening for those with intellectual disabilities in Scotland. British Journal of Health Psychology, 31, e70092. https://doi.org/10.1111/bjhp.70092
Winer, R., Lin, J., Tiro, J., Miglioretti, D. L., Beatty, T., Gao, H., … Buist, D. (2022). Effect of Patient Characteristics on Uptake of Screening Using a Mailed Human Papillomavirus Self-sampling Kit. JAMA Network Open, 5(11), e2244343. https://doi.org/10.1001/jamanetworkopen.2022.44343
Wolf, J., Kist, L., Pereira, S., Quessada, M., Petek, H., Pille, A., Maccari, J., Mutlaq, M., & Nasi, L. (2024). Human papillomavirus infection: Epidemiology, biology, host interactions, cancer development, prevention, and therapeutics. Reviews in Medical Virology, 34(3), e2537. https://doi.org/10.1002/rmv.2537
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2026 Jessica Lisbeth Abarca Wuilcapi, Yisela Carolina Ramos Campi
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial 4.0.
