A study supports anal self-sampling as a reliable tool for HPV detection in higher-risk populations

A multicentre study led by professionals from the Centre for Epidemiological Studies on HIV/AIDS and STI of Catalonia (CEEISCAT) -a research group of the Germans Trias i Pujol Research Institute (IGTP) - and  the Institut Català d'Oncologia (ICO-IDIBELL), published in the Journal of Medical Virology, concludes that anal self-sampling for the detection and genotyping of human papillomavirus (HPV) is an accurate, feasible and well-accepted strategy among gay, bisexual and other men who have sex with men (GBMSM) and trans people in the Barcelona metropolitan area.

The article, entitled "Concordance and Acceptability of Self- Vs. Clinician-Collected Anorectal Swabs for HPV Genotyping in Gay, Bisexual and Other Men Who Have Sex With Men in Metropolitan Barcelona", assesses the concordance between self-collected anal samples and samples collected by healthcare professionals for HPV genotyping, as well as the acceptability of the procedure among participants.

The study was carried out in three HIV units at three hospitals in the Barcelona metropolitan area: Germans Trias i Pujol University Hospital, Vall d'Hebron University Hospital and Bellvitge University Hospital. It included 151 participants. The results show a high overall concordance of 96.0% between the two sampling methods, with a sensitivity of 96.4% - detecting almost all positive cases - and a specificity of 90.9% - correctly identifying most negative cases - for overall HPV detection. These results indicate that self-sampling is able to correctly identify the vast majority of HPV infections, with a performance comparable to that of clinician-collected sampling. In addition, most participants rated self-sampling as an acceptable, simple and satisfactory method.

The findings reinforce the potential of self-sampling as a tool to expand access to anal HPV screening in key populations at higher risk of anal squamous cell carcinoma, especially in contexts where barriers to access, stigma or discomfort associated with conventional clinical testing persist.

"The good concordance observed between self-sampling and samples collected by professionals shows that this strategy can be a reliable alternative to facilitate access to HPV screening in populations at higher risk," says Cristina Agustí, co-author of the study and researcher at CEEISCAT.

Sònia Paytubi, also co-author and researcher at the Infections and Cancer Laboratory (ICO-IDIBELL), adds: "The anal samples collected by the participants correctly identify the vast majority of infections and provide results very similar to those obtained in clinical settings, while also remaining stable under conditions that allow for flexible use outside the clinical environment."

The results presented correspond to the aSELF-GEN study, which lays the groundwork for the deployment of TESTATE Papi, an online tool aimed at screening for anal dysplasia and cancer in GBMSM and trans people living with HIV. The study also shows that the samples remain stable even under high-temperature conditions, reinforcing their suitability for postal delivery.

Overall, the findings support the incorporation of anal self-sampling as a complementary strategy in future anal HPV screening programmes and recommendations for populations at higher risk.

This study was led by professionals from the Centre for Epidemiological Studies on Sexually Transmitted Infections and AIDS of Catalonia (CEEISCAT), part of the Department of Health and also a research group of the Germans Trias i Pujol Research Institute (IGTP), together with the Institut Català d’Oncologia (ICO) and the Bellvitge Biomedical Research Institute (IDIBELL).

The following institutions also participated in the study:

• School of Public Health Pasteur-Cnam, Paris, France
• Department of Paediatrics, Obstetrics and Gynaecology, and Preventive Medicine, Universitat Autònoma de Barcelona
• Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III
• HIV and STI Unit, Infectious Diseases Department, Bellvitge University Hospital
• Infectious Diseases Department, Fight AIDS Foundation, Germans Trias i Pujol Hospital
• Drassanes-Vall d'Hebron STI and HIV Unit, Vall d'Hebron University Hospital

Reference

L. Ferrera, H. Martínez-Riveros, M. Saña, et al., Concordance and Acceptability of Self- Vs. Clinician-Collected Anorectal Swabs for HPV Genotyping in Gay, Bisexual and Other Men Who Have Sex With Men in Metropolitan Barcelona, Journal of Medical Virology 98 (2026): e70908. DOI: 10.1002/jmv.70908