Self-collection for HPV testing can reduce cervical cancer screening disparities in Brazil

Brazil is facing a concerning rate of cervical cancer, with approximately 19,000 new cases annually, largely due to low screening adherence. Many women avoid traditional gynecological exams due to embarrassment, discomfort, or limited access to healthcare. Historically, the Pap smear was the primary screening method, but Brazil has now adopted new guidelines prioritizing HPV molecular testing. This shift allows for sample collection by healthcare professionals or through self-collection by the woman, a method that is quick, painless, and can be done conveniently at home or elsewhere. This new approach, detailed in the 2025 Brazilian Guideline for Cervical Cancer Screening, aligns Brazil with international strategies for eliminating cervical cancer as a public health issue. The molecular HPV test is more sensitive than the Pap smear in detecting pre-cancerous lesions and will gradually replace it in the SUS over the next five years. A particular focus is being placed on improving equity, as Black, urban, and quilombola women experience disproportionately higher rates of cervical cancer and mortality. A study funded by CNPq, titled "Self-collection for HPV testing as a strategy for promoting equity and reducing morbidity and mortality from cervical cancer in Black women from different Brazilian macro-regions," is evaluating the acceptability and adherence of these specific populations to self-collection. This project, involving 600 women across Maringá, Dourados, Manaus, Natal, and Recife, aims to demonstrate that self-collection can be an effective and accessible strategy to increase screening rates among these vulnerable groups. The findings could inform public health policies, encouraging the integration of self-collection into official prevention programs to enhance health equity.