{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T10:49:50Z","timestamp":1791888590934,"version":"4.3.4"},"reference-count":31,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Womens Health (Lond Engl)"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:p>Cervical cancer is highly preventable through regular screening and vaccination. The World Health Organization and governments worldwide have identified the elimination of cervical cancer as a public health problem, as an attainable goal, representing a major advancement in women\u2019s health. While screening has traditionally relied on the Papanicolaou test (Pap test), evidence shows that HPV DNA testing is more accurate in detecting cervical precancers. HPV testing can be performed using clinician-collected or self-collected samples, with self-sampling shown to improve screening access and uptake across diverse populations (e.g., racial or ethnic minority persons, gender minority persons, newcomers) and settings (e.g., rural areas, geographically hard to reach). Despite this potential, several behavioural, structural, and system-level barriers continue to limit widespread uptake of HPV self-sampling. In this work, we argue that behavioural science is central to addressing these barriers. We apply the Capability, Opportunity, Motivation-Behaviour (COM-B) model to identify key barriers and propose multi-level, theory-informed strategies that span individuals, healthcare providers, and health systems to enhance the capability, opportunity, and motivation of women and people with a cervix (WPC) to engage in HPV self-sampling. Targeted education, coaching, strong provider-patient engagement, accessible kit distribution and return pathways, and meaningful community involvement may collectively strengthen uptake of HPV self-sampling and accelerate progress toward global cervical cancer elimination.<\/jats:p>","DOI":"10.1177\/17455057261484755","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T21:06:10Z","timestamp":1791493570000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrating behavioural science into HPV self-sampling and cervical cancer elimination strategies"],"prefix":"10.1177","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0401-2539","authenticated-orcid":false,"given":"Kimberly","family":"Devotta","sequence":"first","affiliation":[{"name":"Women's College Research and Innovation Institute, Women\u2019s College Hospital,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aisha","family":"Lofters","sequence":"additional","affiliation":[{"name":"Women's College Research and Innovation Institute, Women\u2019s College Hospital,"},{"name":"University of Toronto"},{"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ambreen","family":"Sayani","sequence":"additional","affiliation":[{"name":"Women's College Research and Innovation Institute, Women\u2019s College Hospital,"},{"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2214-8263","authenticated-orcid":false,"given":"Gilla K.","family":"Shapiro","sequence":"additional","affiliation":[{"name":"University of Toronto"},{"name":"Princess Margaret Cancer Centre"},{"name":"University Health Network"},{"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"e_1_3_3_2_2","volume-title":"World Health Organization","author":"Global Cancer Observatory","year":"2022","unstructured":"Global Cancer Observatory. World Health Organization. Cervix Uteri, 2022. https:\/\/gco.iarc.who.int\/media\/globocan\/factsheets\/cancers\/23-cervix-uteri-fact-sheet.pdf accessed 24 March 2026."},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0849-5831(16)31416-1"},{"key":"e_1_3_3_4_2","first-page":"1","article-title":"Human papillomavirus-based vs. cytology for cervical cancer screening: a systematic review with meta-analysis","volume":"48","author":"Rocha KC","unstructured":"Rocha KC, Castanha EB, Elias MEM, et al. Human papillomavirus-based vs. cytology for cervical cancer screening: a systematic review with meta-analysis. Revista Brasileira de Ginecologia e Obstetr\u00edcia, 48: 1. https:\/\/doi.org\/10.61622\/rbgo\/2026rbgo130, Epub ahead of print March 25, 2026.","journal-title":"Revista Brasileira de Ginecologia e Obstetr\u00edcia"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.31128\/AJGP-01-18-4471"},{"key":"e_1_3_3_6_2","unstructured":"White R. Australia on track to eliminate cervical cancer by 2035 2025. https:\/\/www.health.gov.au\/ministers\/the-hon-rebecca-white-mp\/media\/australia-on-track-to-eliminate-cervical-cancer-by-2035?language accessed 03 February 2026."},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2004.011858"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-25-0362"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1089\/lgbt.2019.0202"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2016-052609"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-023-02174-w"},{"key":"e_1_3_3_12_2","first-page":"1","article-title":"Self-Sampling for Human Papillomavirus Testing: Increased Cervical Cancer Screening Participation and Incorporation in International Screening Programs","volume":"6","author":"Gupta S","unstructured":"Gupta S, Palmer C, Bik EM, et al. Self-Sampling for Human Papillomavirus Testing: Increased Cervical Cancer Screening Participation and Incorporation in International Screening Programs. 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Facilitators and Barriers to Uptake of Community-Based Diabetes Prevention Program Among Multi-Ethnic Asian Patients With Prediabetes. 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The Effect of Peer-Led Navigation Approach as a Form of Task Shifting in Promoting Cervical Cancer Screening Knowledge, Intention, and Practices Among Urban Women in Tanzania: A Randomized Controlled Trial. Cancer Control, 29: 1. https:\/\/doi.org\/10.1177\/10732748221089480, Epub ahead of print November 6, 2022.","journal-title":"Cancer Control"},{"key":"e_1_3_3_28_2","volume-title":"WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention","year":"2024","unstructured":"WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention: use of dual-stain cytology to triage women after a positive test for human papillomavirus (HPV). Geneva: World Health Organization. WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention, second edition. 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