Mailing Self-Sampling Kits Can Increase HPV and Cervical Cancer Screening
Mailing cervical cancer screening kits directly to people’s home may be a good strategy for getting more people screened, a new study says.
Cervical cancer is most often caused by HPV and is highly preventable. The HPV vaccine protects against the types of HPV that cause almost all cervical cancers. Regular screening can also detect abnormal changes to cervical cells years before cancer develops. These changes can be treated before they become cancer.
Cervical cancer screening is most often done in a health care provider’s office using either a Pap test, an HPV test, or both. But screening has declined in recent years. One in four women don’t receive regular HPV screenings. Research has found that half of all diagnosed cervical cancers occur in people who were never screened or had not been screened in over five years.
At-home testing might be a way to increase the number of people screened. Similar to other home STI tests, a home HPV test involves swabbing your own cervix and sending the sample to a lab for analysis. Research has suggested these samples can be as accurate as those done in a doctor’s office. But these tests have not yet been approved by the FDA.
Researchers at Kaiser Permanente in Washington have been looking for way to increase screening using home tests. For a study published last summer, researchers mailed kits to 16,900 people who were overdue for their cervical cancer screening. They found that this strategy increased screening by 50% with this group.
Their most recent study was published in the Journal of the American Medical Association (JAMA) in late November. This was a randomized controlled trial comparing different strategies among different groups. The study included over 33,000 people divided into three groups: those who were on time/due for their cervical cancer screening, those who were overdue, and those whose last screening was unknown.
Everyone received usual care which was essentially a reminder that it was time to make a screening appointment. Participants who were due or overdue were then randomly selected to receive educational material on screening, educational material on screening that included information on ordering a test kit, or a complete test kit.
Among patients who were due for screening, 62% who received the complete kits were screened within six months compared to 51% who were given the option to request a test kit and 48% of those who just got educational material.
Among those who were overdue for screening, 36% who received the kits were screened within six months compared to 19% of those who just got educational material.
The results also show that people who got a complete kit were screened sooner than people who had to request a home test kit (a median of 28 days compared to 39 or 41 days).
Rachel Winer PhD, MPH, of the University of Washington in Seattle, was lead researcher on this study. She told MedPage Today: “This direct mail approach was very effective for increasing screening rates regardless of whether you were overdue or previously due for screening.”
There are home screening kits for HPV and cervical cancer that you can buy online or in pharmacies. While the FDA has not yet approved these kits, most experts agree that they should be accurate. That said, home test kits might not look for as many types of HPV as the tests offered by a health care provider.
Whether you test at home or see your doctor, regular screenings are an important tool in preventing cancer. Which tests you should use and how often you should be screened depends on your age and history. See these guidelines or ask your health care provider. In addition, the HPV vaccine is now available for people ages 9 to 45. Researchers believe that widespread use of this vaccine could eliminate cervical cancer in this country. If you or your child has not yet been vaccinated, talk to your health care provider.