{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T16:25:32Z","timestamp":1783355132735,"version":"3.54.6"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T00:00:00Z","timestamp":1745366400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Cervical cancer, driven by persistent high-risk human papillomavirus (hrHPV) infection, remains a global health challenge, especially in low- and middle-income areas such as western China. Despite the critical role of HPV testing in early detection, coverage in China remains low due to cultural, psychological, and other barriers. Self-collected urine and vaginal samples offer alternative methods for sample collection. This study aimed to evaluate the feasibility and acceptability of detecting hrHPV and cervical intraepithelial neoplasia grade 2 or worse (CIN2+) via urine and vaginal self-sampling compared with clinician sampling in urban areas of western China.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross-sectional survey was conducted from November 2022 to March 2023 in urban areas of western China. The participants provided self-collected urine and vaginal samples for hrHPV testing and completed questionnaires on acceptability of self-sampling. The HPV positivity, agreement, and kappa value were calculated to assess concordance between self- and clinician sampling. The sensitivity, specificity, agreement, predictive values, and likelihood ratios were used to evaluate the clinical performance of both methods for detecting CIN2+.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 2,228 female subjects aged 21\u201371\u202fyears were recruited, and self-collected urine samples, vaginal samples, and clinician-collected cervical samples were obtained. The sensitivity of clinician sampling, urine self-sampling and vaginal self-sampling were 80.00% (95% CI: 44.22\u201396.46), 70.00% (95% CI: 35.37\u201391.91) and 90.00% (95% CI: 54.12\u201399.48) for CIN2+; the specificity for &amp;lt;CIN2 were 98.33% (95% CI: 97.68\u201398.81), 98.23% (95% CI: 97.56\u201398.72) and 98.50% (95% CI: 97.87\u201398.95%); and the agreements for CIN2+ were 98.25% (95% CI: 97.59\u201398.74), 98.83 (95% CI: 98.26\u201399.22) and 98.82 (95% CI: 98.25\u201399.21). All methods yielded high negative predictive values, high positive likelihood ratios, and low negative likelihood ratios. Additionally, participants reported high acceptability of self-sampling, citing less discomfort and embarrassment than clinician sampling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Self-collected urine and vaginal samples for the detection of hrHPV and CIN2+ demonstrate high diagnostic accuracy and acceptability, making them viable alternatives to clinician-collected samples. Self-sampling methods may improve screening accessibility and compliance, especially in resource-limited settings, thereby supporting the prevention and early detection of CIN2+.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1524796","type":"journal-article","created":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T05:21:45Z","timestamp":1745385705000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Feasibility and acceptability of human papillomavirus self-sampling compared with clinician sampling in urban areas of western China: a cross-sectional survey"],"prefix":"10.3389","volume":"13","author":[{"given":"Shaolong","family":"Xue","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leni","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingrong","family":"Xi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lian","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengyin","family":"Ao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxi","family":"Yao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongmei","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangdong","family":"Liao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","article-title":"Global 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