The data are now overwhelming that the most cost-efficient primary screen for women over the age of 30–35 should be a test for high-risk types of human papillomavirus. A self-collected sample expands coverage by overcoming many of the known obstacles to participation in a screening programme. In addition, self-sampling has the potential to be the most effective means to achieve high coverage rates in medically underserved regions of the world that lack the healthcare infrastructure to support traditional screening programmes. Self-collection combined with high throughput, low cost-per-case, polymerase chain reaction-based technology has the sensitivity of a direct endocervical sample obtained by a physician. Therefore, we have the technology to reach millions of women around the world in a short period of time through large ‘event-type’ screening programmes and centralised testing. Now we need to focus on developing the models that will enable us to efficiently place the technologies next to the women who need them the most.
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