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In high\u2010income countries with long\u2010standing, organised cervical screening programmes, self\u2010collection is increasingly becoming available as a routine offer for women regardless of their screening histories, including under\u2010 and well\u2010screened women. For these contexts, a validated microsimulation model determined that adding self\u2010collection to clinician collection is likely to be cost\u2010effective on the condition that it meets specific thresholds relating to (1) uptake and (2) sensitivity for the detection of high\u2010grade cervical intraepithelial neoplasia (CIN2+). We used these thresholds to review the \u2018early\u2010adopter\u2019 programme\u2010level evidence with a mind to determine how well and how consistently they were being met. The available evidence suggested some risk to overall programme performance in the situation where low uptake among underscreened women was accompanied by a high rate of substituting clinician sampling with self\u2010collection among well\u2010screened women. Risk was further compounded in a situation where the slightly reduced sensitivity of self\u2010sampling vs clinician sampling for the detection of CIN2+ was accompanied with lack of adherence to a follow\u2010up triage test that required a clinician sample. To support real\u2010world programmes on their pathways toward implementation and to avoid HPV self\u2010collection being introduced as a screening measure in good faith but with counterproductive consequences, we conclude by identifying a range of mitigations and areas worthy of research prioritisation.<\/jats:p>","DOI":"10.1002\/ijc.34358","type":"journal-article","created":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T03:09:47Z","timestamp":1668654587000},"page":"8-19","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Widening the offer of human papillomavirus self\u2010sampling to all women eligible for cervical screening: Make haste slowly"],"prefix":"10.1002","volume":"153","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9597-645X","authenticated-orcid":false,"given":"Matejka","family":"Rebolj","sequence":"first","affiliation":[{"name":"Cancer Prevention Group, School of Cancer &amp; Pharmaceutical Sciences, Faculty of Life Sciences &amp; Medicine King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9354-7720","authenticated-orcid":false,"given":"Alexandra","family":"Sargent","sequence":"additional","affiliation":[{"name":"Cytology Department, Manchester Royal Infirmary Manchester University NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0429-4176","authenticated-orcid":false,"given":"Sisse Helle","family":"Njor","sequence":"additional","affiliation":[{"name":"University Research Clinic for Cancer Screening, Department of Public Health Programmes Randers Regional Hospital  Randers Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2604-3928","authenticated-orcid":false,"given":"Kate","family":"Cuschieri","sequence":"additional","affiliation":[{"name":"Scottish HPV Reference Laboratory, Royal Infirmary of Edinburgh, NHS Lothian Scotland  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,11,23]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2021.106900"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62218-7"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2012.03344.x"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2016-052609"},{"key":"e_1_2_12_6_1","unstructured":"Rijksinstituut voor Volksgezondheid en Milieu.Monitor bevolkingsonderzoek baarmoederhalskanker 2009\u20102021.https:\/\/www.rivm.nl\/bevolkingsonderzoek\u2010baarmoederhalskanker\/professionals\/monitoring\u2010en\u2010evaluatie. 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