July 25, 2017
A new study finds a convenient at-home test for human papillomavirus (HPV) to be a promising tool for preventing cervical cancer in underscreened women in the United States.
Jennifer S. Smith, PhD, professor of epidemiology at the UNC Gillings School of Global Public Health, is lead author of the study, published online July 21 in the journal Sexually Transmitted Diseases. Smith is also a member of the UNC Lineberger Comprehensive Cancer Center.
This year, about 12,820 women in the U.S. will be diagnosed with invasive cervical cancer, and close to one-third of them will die from this highly preventable disease. Half of the cases in the U.S. are in women who are never or rarely screened.
Lack of health insurance and poor access to medical services are major reasons that women do not receive screening. However, women also may be embarrassed or feel discomfort when undergoing a Pap test. The home self-test alleviates that barrier.
In the “My Body, My Test” study, Smith and colleagues recruited 429 women in North Carolina who were overdue for a Pap test, which analyzes cervical cells for the presence of cancer. Participants, ages 30 to 65 years, received a kit by mail to self-collect a cervico-vaginal sample, return it by mail, and get their HPV results by telephone. Participants also received information about where to receive affordable Pap testing at a local clinic.
Of the 275 women who returned a sample, 15 percent tested positive for HPV. An exciting outcome was that of the women who had HPV, 82 percent followed through with a follow-up in-clinic appointment for Pap testing.
“Our study aimed to approximate a scalable model for increasing coverage among infrequently screened women by incorporating at-home HPV self-testing into a screening program,” Smith said. “Mailing self-collection kits was feasible, with high return rates among women with infrequent screening histories. Our findings add to growing evidence that HPV self-testing can be a powerful tool to engage hard-to-reach women at higher risk of cervical cancer into preventative screening.”
“Every year, phone surveys identify thousands of women all over the country who need screening for cervical cancer,” said Noel T. Brewer, PhD, professor of health behavior at the Gillings School, UNC Lineberger member and senior author of the study. “Dr. Smith’s research shows an important way to get these women screened by mail.”
Andrea C. Des Marais, MPH, project manager in epidemiology at the Gillings School, is also a co-author. Additional co-authors are Allison M. Deal, MS, of UNC Lineberger; Alice R. Richman, PhD, of East Carolina University; Carolina Perez-Heydrich, PhD, of Meredith College; Belinda Yen-Lieberman, MD, and Jerome Belinson, MD, of the Cleveland Clinic; and Lynn Barclay, of the American Sexual Health Association.