Smith receives NCI funding to study use of HPV self-collection in cervical cancer screening

April 23, 2015

Dr. Jennifer Smith

Jennifer Smith, PhD, associate professor of epidemiology at the UNC-Chapel Hill Gillings School of Global Public Health, has been awarded a large RO1 grant, “Effect of HPV Self-Collection on Cervical Cancer Screening in High-Risk Women,” from the National Cancer Institute (NCI). The funds will support a five-year randomized control trial in North Carolina to assess whether testing women for human papillomavirus (HPV) using mailed, self-collected samples will improve cervical cancer screening completion among high-risk women.

Though modern approaches to screening and early treatment have dramatically lowered rates of invasive cervical cancer, over one-fifth of women in the United States do not complete recommended screening. More than half of invasive cervical cancer cases occur in these under-screened women. Self-collection for HPV testing has been found to be a valid and well-accepted method for detecting HPV infection, with comparable sensitivity to physician collection for detecting high-grade precancerous lesions.

“Women who are under-screened generally fall outside the regular health care system,” Smith said. “Many of these women face structural barriers such as lack of transportation, or personal barriers such as embarrassment. This project takes a novel approach to improving access to screening by providing these women with a self-sampling kit that they can complete at home.”

Through collaboration with Gillings School co-investigators Noel Brewer, PhD, associate professor of health behavior, Michael Hudgens, PhD, associate professor of biostatistics, and Stephanie Wheeler, PhD, assistant professor of health policy and management, the study will also examine possible psychological mechanisms explaining the intervention’s effect, and assess relative costs of HPV self-collection compared to clinic referral.

“I’m excited about the science in this project,” shared Smith. “Through a randomized controlled trial, we can look at self-collection with referral of only HPV-positive women to clinic screening compared to referral alone, and determine if this is an effective way to boost cervical cancer screening among women who currently are not getting screened on schedule. Hopefully, the opportunity to self-sample at home will reduce barriers to initial screening.”

If the approach is found to be effective, clinics and other organizations could implement it as an outreach strategy for improving community screening coverage. Increasing early detection of high-grade precancerous cervical lesions would have a major public health impact by reducing suffering and death from cervical cancer nationwide.