The co-creation of a document to guide the use of self-sampling for human papillomavirus screening in Italy

Sep 23, 2026

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The article addresses inequities in cervical cancer risk and screening access faced by vulnerable women. It documents the co-creation of an implementation guide for human papillomavirus self-sampling in Italy, developed through a collaborative user board process. Informal interviews with women informed discussions grounded in systematic reviews, program reports, and national self-sampling pilots. The guide compiles barriers across vulnerable groups and evaluates evidence-based strategies, concluding that mailing self-sampling devices to non-responders has sufficient evidence to increase participation.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions

Background

Screening inequalities and policy context

The co-creation of a document to guide the use of self-sampling for human papillomavirus screening in Italy Laura Bonvicini 1, Giusy Iorio2 , Luca Ghirotto2 , Noemi Auzzi3 , Marc Bardou4, Rikke Buus Bøje5 , Pia Kirkegaard6,7, Paola Mantellini3,* , Paolo Giorgi Rossi 1,* , Italian Collaborative User Board Working Group, and CBIG-SCREEN Consortium J Med Screen 2026, Vol. 33(3) 163–171 © The Author(s) 2026 Article reuse guidelines: [sagepub.com/journals-permissions](sagepub.com/journals-permissions)[ ](sagepub.com/journals-permissions)[DOI: 10.1177/09691413261429385](DOI: 10.1177/09691413261429385)[ ](DOI: 10.1177/09691413261429385)[journals.sagepub.com/home/msc](journals.sagepub.com/home/msc) Abstract Background: Vulnerable women face a higher risk of cervical cancer and reduced access to screening. Self-sampling may increase access to human papillomavirus screening. In this article, we report the co-creation of a document to guide the implementation of human papillomavirus self-sampling in Italy. Methods: Working CollaBoratively with vulnerable women to Identify the best implementation Gains by SCREEning cervical cancer more effectively in European countries (CBIG-SCREEN) project, a Collaborative User Board has been set up in Italy, including national decision-makers, healthcare providers, and vulnerable women. To ensure that women’s direct perspectives were incorporated into the process, informal individual interviews were carried out and brought to the Collaborative User Board meetings. The Collaborative User Board discussion was based on systematic reviews, screening program reports, and Italy’s self-sampling pilots. Results were summarized with a matrix of vulnerable groups and barriers to evaluate interventions’potential ability to remove barriers. Considerations were collected in a document for screening program coordinators and decision-makers. Results: The Collaborative User Board identiﬁed major barriers to cervical cancer screening among different vulnerable groups and assessed ﬁve evidence-based strategies to address them: multilingual structured invitation letters, group training led by cultural mediators, training for healthcare professionals, training for third-sector operators, and self-sampling. Evaluating the potential of these strategies to remove barriers led to a focus on self-sampling. Mailing the device to all non-responders was the only strategy with sufﬁcient evidence to increase participation in Italy. An opportunistic offer in a setting attended by vulnerable women is promising. The Collaborative User Board underscored the importance of improving healthcare providers’ communication. Conclusions: The ﬁnal document, created through a transparent and collaborative bottom-up process, collects considerations for implementing self-sampling for human papillomavirus testing. Keywords Cervical cancer screening, co-creation, vulnerability, self-sampling Date received: 28 July 2025; accepted: 6 February 2026 1 Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Emilia-Romagna, Italy 2Qualitative Research Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Emilia-Romagna, Italy 3Screening and Secondary Prevention Unit, Istituto per lo Studio, la Prevenzione e la Rete Oncologica, Firenze, Tuscany, Italy 4CIC-P INSERM 1432, Centre Hospitalier Universitaire de Dijon, Dijon, France 5Research Centre for Social Marginalisation, VIA University College, Aarhus, Denmark 6UNICCA - University Research Clinic for Cancer Screening, Randers, Denmark 7Department of Clinic Medicine, Aarhus Universitet faculty of Health, Aarhus, Denmark *Equal contribution as last authors. Corresponding author: Giusy Iorio, Qualitative Research Unit, Azienda USL-IRCCS di Reggio Emilia, Viale Umberto I, 50 42123 - Reggio Emilia, Emilia-Romagna 42122, Italy. Email: [giusy.iorio@ausl.re.it](giusy.iorio@ausl.re.it) Background Cervical cancer rates in Europe are declining both in

FAQs

Why is human papillomavirus self-sampling important for vulnerable women in Italy?

Vulnerable women face higher cervical cancer risk and reduced access to screening. Self-sampling may increase access to HPV screening and participation.

How was the guide for self-sampling co-created?

A Collaborative User Board in Italy worked with vulnerable women through informal interviews, then discussed evidence using systematic reviews, screening program reports, and Italy’s self-sampling pilots.

Which strategies were assessed to address barriers to screening, and what was the key evidence for participation?

The board assessed five evidence-based strategies: multilingual structured invitation letters, group training led by cultural mediators, training for healthcare professionals, training for third-sector operators, and self-sampling. Mailing the device to all non-responders was the only strategy with sufficient evidence to increase participation in Italy.

Sep 23, 2026

Uploaded by OmBimo