Community-Based HPV Self-Sampling to Enhance Access to Cervical Cancer Prevention: A Continuum-of-Care Model from Urban Nepal

Abstract

Simple Summary Cervical cancer remains a major health problem in Nepal, yet many women do not participate in screening because of barriers such as travel, limited time, privacy concerns, and household responsibilities. This study evaluated the feasibility and acceptability of a community-based, door-to-door screening approach in which trained community health workers visited homes, provided education, and supported women in collecting their own samples for human papillomavirus (HPV) testing. Among the 418 asymptomatic women screened, approximately 1 in 10 tested positive for high-risk HPV, with several HPV genotypes identified. Women who tested positive were successfully linked to follow-up evaluation, including visual inspection with acetic acid (VIA), diagnostic assessment, and treatment when needed. The program was delivered through a partnership involving local government, community health workers, and private healthcare providers, creating a screen–triage–treat continuum. This community-centered model demonstrates high acceptability and feasibility and offers a scalable framework for expanding cervical cancer prevention services in Nepal.