Exploring the promise of at-home cervical cancer screening

Scientific breakthroughs in cancer screening have saved many lives over the past decades. But sometimes the biggest barrier to effective cancer screening isn’t scientific knowledge — it’s what people have to do to get screened.

Take cervical cancer. There are several ways to help prevent cervical cancer. One way is to identify and remove precancers caused by high-risk strains of the human papillomavirus, or HPV.

Screening for HPV in people with cervixes has reduced deaths from cervical cancer in the United States by half over the last 50 years. But recently screening rates have been declining.

Barriers to cervical cancer screening

One in 4 women don’t receive regular HPV screenings. And half of all diagnosed cervical cancers occur in people who are not screened.

When asked why they miss cervical cancer screenings, people point to many barriers. Many lack the time and transportation to get to screening appointments. Others say screenings are uncomfortable or embarrassing. And, pelvic exams can be triggering for people who have experienced trauma.

Researchers at the Kaiser Permanente Washington Health Research Institute set out to see if more convenient options could encourage more people to get screened. What we’re learning could change the landscape of cervical cancer screening for patients everywhere.

Testing for HPV at home

Kaiser Permanente has already had success boosting colorectal cancer screening rates by mailing at-home tests to members who are due for screenings. Using that as a model, our team conducted a study to see if at-home tests for HPV could increase screening rates for cervical cancer.

The research study included 16,590 participants from 30 to 65 years old. They received home kits with everything they needed to collect a sample swab and return their samples to our labs for testing to see if they had the HPV strains most likely to cause cervical cancer. They received results and follow-up care just like patients who had been screened in one of our clinics.

Our research showed that samples collected at home detect HPV just as well as samples collected by a clinician.

Our team also tracked response rates when they mailed HPV testing kits to people who were overdue for cervical cancer screening. Mailing HPV kits increased screening by more than 50%. A follow-up survey showed that people who returned the kits had very positive feelings about the experience.

Learning how to improve the experience of at-home HPV testing

People who didn’t return the kits said they felt unsure about how to use them correctly. Other common reasons included not wanting to insert the swab and being embarrassed to use the kit.

Our team is working on addressing these challenges in an ongoing study of 33,000 people. The study explores different outreach approaches based on participants’ prior screening behavior. It also explores whether information included with the mailed test kits can motivate individuals to get screened.

The future of at-home HPV tests

Although several countries use at-home HPV tests, the U.S. Food and Drug Administration has not yet approved the kits. Research at Kaiser Permanente and other institutions is helping to pave the way for their approval in the United States.

At-home HPV testing kits would give people a more convenient choice for early detection of cervical cancer. For some people, that choice could save their lives.

Learn more about cancer care at Kaiser Permanente.