肛门鳞状细胞癌（ASCC）的发病率在全球范围内不断增加。 2024 年发布的国际共识指南包括对 ASCC 风险最高的人群进行肛门拭子的 HPV 和/或细胞学检测。自行采集的肛门拭子对于提高筛查率可能很重要，但需要证据证明它们与临床医生采集的拭子的等效性。我们检索了 Medline、Embase、Cochrane Library 和 CINAHL 数据库中截至 2023 年 6 月 13 日的出版物。如果报告了自我和临床医生收集的肛门拭子的 HPV 检测、细胞学检测或可接受性数据，则纳入研究。使用 QUADAS-2 评估工具评估偏倚风险。主要结果是 HPV 和细胞学采样充足性。次要结果是 HPV 和细胞学结果以及采集方法的可接受性。描述 10 项研究的 13 篇论文符合资格。用于 HPV 检测的自行采集拭子和临床医生采集的拭子的样本充足性相当（元充足比：1.01 [95% CI 0.97-1.05]），但自行采集的细胞学样本充足性略低（元充足比：0.91 [95%]） CI 0.88-0.95]）。患病率无显着差异（元患病率：任何 HR-HPV 为 0.83 (95% CI 0.65-1.07)，任何 HPV 为 0.98 (95% CI 0.84-1.14)，任何 HPV 为 0.68 (95% CI 0.33-1.37) ) HPV16)，或任何细胞学异常（元患病率 1.01 [95% CI 0.86-1.18]）。只有三篇论文报告了可接受的结果。研究结果表明，自行采集的样本对于 HPV 检测的充足性相当，而对于细胞学检测的充足性则较差 10%。 HPV 和细胞学的元患病率相似，但置信区间较宽。需要进行更大规模的研究来明确评估在肛门癌筛查项目中使用自取拭子的情况，包括可接受性。© 2024 UICC。

Anal squamous cell carcinoma (ASCC) incidence is increasing globally. International consensus guidelines published in 2024 include HPV and/or cytology testing of anal swabs in those at greatest risk of ASCC. Self-collected anal swabs may be important for increasing screening uptake, but evidence is needed as to their equivalence to clinician-collected swabs. We searched Medline, Embase, Cochrane Library, and CINAHL databases for publications to 13 June 2023. Studies were included if reporting data on HPV testing, cytology testing, or acceptability, for both self- and clinician-collected anal swabs. Risk of bias was assessed using the QUADAS-2 assessment tool. The primary outcome was HPV and cytology sampling adequacy. Secondary outcomes were HPV and cytology results, and acceptability of collection methods. Thirteen papers describing 10 studies were eligible. Sample adequacy was comparable between self- and clinician-collected swabs for HPV testing (meta-adequacy ratio: 1.01 [95% CI 0.97-1.05]) but slightly lower for cytology by self-collection (meta-adequacy ratio: 0.91 [95% CI 0.88-0.95]). There was no significant difference in prevalence (meta-prevalence ratio: 0.83 (95% CI 0.65-1.07) for any HR-HPV, 0.98 (95% CI 0.84-1.14) for any HPV, and 0.68 (95% CI 0.33-1.37) for HPV16), or any cytological abnormality (meta-prevalence ratio 1.01 [95% CI 0.86-1.18]). Only three papers reported acceptability results. Findings indicate self-collection gives equivalent sample adequacy for HPV testing and ~ 10% inferior adequacy for cytological testing. Meta-prevalence was similar for HPV and cytology, but confidence intervals were wide. Larger studies are required to definitively assess use of self-collected swabs in anal cancer screening programs, including acceptability.© 2024 UICC.