Optimisation of a Cervical Cancer Screening Model Based on Self-Sampling for Human Papillomavirus Testing

Introduction Cervical cancer remains a significant cause of morbidity and mortality among women globally, despite the availability of effective prevention tools. The use of self-sampling devices for human papillomavirus (HPV) testing is a promising strategy to increase screening participation, particularly in settings dominated by opportunistic models. Understanding women’s preferences regarding invitation methods and device design is essential to ensure effective and equitable programme implementation. This study explored the expectations, preferences, and perceived barriers of women aged 35 to 65 in the Valencian Community (VC), Spain, in anticipation of launching a population-based cervical screening program. Methods A qualitative study was conducted using four face-to-face focus groups involving 29 women, selected from the target population of the screening programme (healthy women aged 35-65 residing in the VC). The session combined an individual assessment (questionnaire and electronic response system of five self-sampling devices) with a structured group discussion. Preferences regarding invitation channels, test communication, and device usability were analyzed through descriptive statistics and thematic content analysis. Results Self-sampling was highly accepted, with 96.4% of women stating they would perform it at home. Preferred channels for both invitations and results were SMS and local health centers. Simplicity and ease of use were the key features of the device accepted by the largest number of women—FLOQSwab. Evalyn Brush was also positively valued for its attractive design and was the preferred option for some women. Participants expressed concerns about reliability and proper use, particularly among older women or those with limited body awareness. Familiarity with colorectal screening supported acceptance. Importantly, device selection emerged as a key factor in facilitating participation. The integration of digital technologies (SMS, health apps) was positively valued as a means of increasing accessibility, improving communication, and supporting equity in outreach efforts. Conclusion Self-sampling is a feasible and widely accepted strategy for cervical cancer screening. Effective implementation requires validated devices, culturally adapted information campaigns, and digital engagement tools to maximize participation and reduce inequalities. Plain Language Summary Cervical cancer can often be prevented with regular screening tests. However, in many places, only women who go to the doctor on their own get tested. This limits how many women are protected. This study looked at a new way to improve participation in cervical cancer screening. It explored what women think about using self-sampling devices (tools that allow women to collect their own samples for HPV testing at home). Researchers wanted to understand which devices women prefer and how they feel about getting invited to screening using digital tools like text messages or health apps. The study included 29 women aged 35 to 65 in the Valencian Community, Spain. They saw five different self-sampling devices and shared their opinions in group discussions. Most women (96%) said they would use self-sampling at home. They preferred simple devices that were easy to use. They also liked being contacted by SMS and having the option to return the sample to a health center. Some women had concerns about doing the test correctly and missing a chance to talk to a doctor. Others felt confident and said it reminded them of the home test for colon cancer. This study shows that self-sampling is well accepted and can help reach more women. Choosing the right device and using modern communication tools may increase screening and reduce health inequalities.