Objectives The efficacy of cervical screening programs is dependent on the participation rate which in Sweden is 83%. To increase participation among women not attending to cervical screening, self-collected samples for detection of high-risk human papillomavirus is an option.

The aims were to investigate the response rate of a self-collected vaginal HPV sample sent to long-term non-attendees and the prevalence of cervical dysplasia among the responders.

Methods A vaginal HPV self-sampling kit was sent to 19,766 women aged 30–70 years with no cervical screening sample for ³7 years. The self-sample was analyzed by Aptima HPV mRNA assay (Hologic). Women positive for HPV mRNA were invited for follow-up.

Results The response rate of the self-collected vaginal HPV sample was 18.5% (3652/19,766). The prevalence of HPV mRNA was 11.0% (402/3,652). The histo-pathologically confirmed prevalence of HSIL or cancer was 7.7% (31/402) in the HPV positive women and in the whole group of responders 0.85% (31/3,652), including two cervical and one vaginal cancer.

Conclusions Self-collected vaginal HPV samples increased coverage in cervical screening among long time non-attendees. The prevalence of HPV mRNA was higher (11%) in long time non-attenders than in women attending the screening program within routine screening intervals (7%) (p<0.001), but the prevalence of HSIL and cervical cancer was similar as in regularly screened women.