A comparison of the carbon footprint of alternative sampling approaches for cervical screening in the UK: a descriptive study

Maya Whittaker, Jennifer C. Davies, Alexandra Sargent, Matt Sawyer, Emma Crosbie

Research output: Contribution to journalArticlepeer-review


Objective: To understand whether self-sampling can reduce carbon emissions (CO2e) from the NHS cervical screening programme (NHSCSP) by comparing the carbon footprint of three sampling strategies: routine cervical sampling, vaginal self-sampling and first-void (FV) urine collection.

Design: Descriptive study
Setting: National Health Service (NHS), United Kingdom (UK) Population or Sample: Patients aged 25-64, eligible for cervical screening in the UK.

Methods: A carbon footprint analysis was undertaken for three cervical screening sampling approaches, from point of invitation to screening through to preparation for transport to the laboratory for HPV testing. A combination of primary and secondary data were used, with a bottom-up approach applied to collection of primary data.

Main Outcome Measures: We report CO2e per sampling approach, which is the unit used to express carbon footprint and harmonise the contributions of greenhouse gases with different global warming potentials.

Results: The total carbon footprint of routine cervical sampling is 3,670gCO2e. By comparison, vaginal self-sampling had a total carbon footprint of 423gCO2e, and FV urine sampling 570gCO2e. The largest share of emissions for routine sampling was attributable to the carbon footprint associated with an appointment in a primary care setting, which totalled 2,768gCO2e.

Conclusions: Routine cervical sampling is up to 8.7-fold more carbon intensive than self-sampling approaches with equivalent effectiveness. We find negligible differences in the carbon footprint of alternative self-sampling methods, supporting the need for an informed choice of screening options for participants, which includes sharing information on their environmental impacts.

Original languageEnglish
Publication statusAccepted/In press - 2 Nov 2023


  • Self-sampling
  • cervical screening
  • screening uptake
  • carbon footprint
  • sustainable healthcare


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