Cervical cancer screenings have helped save many lives over the past 50 years.
These screenings, especially those that detect HPV (human papillomavirus), are very important because HPV causes most cervical cancers.
This month, the U.S. Department of Health and Human Services made a big change to screening guidelines.
Women at average risk can now choose to collect their own HPV samples at home. A few weeks earlier, the American Cancer Society made the same recommendation.
Dr. George F. Sawaya from UCSF is one of the senior authors of a related study. He says that self-collection is preferred by many women, especially those who have never been screened or haven’t been screened in a long time.
Cervical cancer is very preventable. Unlike some cancers that are hard to detect early, cervical cancer develops slowly. It often starts as a precancerous condition that can take up to 10 years to become cancer. This gives doctors plenty of time to find and treat it. Most treatments are quick and easy, usually done in a short office visit.
HPV home testing works by using a special device that allows women to collect a sample themselves. These samples can be collected at home or at a clinic and are sent to a lab for testing. Several of these sampling devices have been approved by the FDA, and UCSF hopes to start offering them to patients soon.
In a large national survey published last year, researchers found that 70% of women aged 21–49 were open to using self-collected HPV tests. That also means about 30% were not, so traditional clinic-based tests will still be available. The goal is to give women more choices in how they want to be screened.
The women most interested in self-collection were those who had not been screened before or had not been screened in a long time. This is great news, because these groups are at the highest risk for cervical cancer.
The option to self-test could help many women who might otherwise skip screening. Other women who preferred self-testing included those who identified as not heterosexual and those who had experienced non-voluntary sexual activity.
Many patients like self-collection because it gives them control. They can do the test privately at home or in a clinic without needing a speculum exam, which some find uncomfortable. This convenience and privacy help more women feel comfortable getting tested.
The biggest benefit of self-collection is that it may help people who wouldn’t get screened otherwise. This could lower their risk of getting cervical cancer.
Not everyone should use self-collection. People with a higher risk include those with weakened immune systems, a history of certain drug exposures before birth, or recent abnormal test results. Doctors can help patients decide which screening method is best for them.
Most guidelines suggest starting HPV screening at age 25 or beginning with Pap tests at 21 and switching to HPV tests at 30. Screening can usually stop at age 65 if results have been normal for the past 10 years.
At UCSF and in other places, research is continuing. Studies are looking at whether self-testing works in other countries like Zimbabwe and whether people over 65 could benefit from continued screening. Other research is exploring HPV vaccines for people with weakened immune systems.
Self-collected HPV tests may change the way cervical cancer is found and prevented, especially for people who have trouble accessing traditional screenings. Giving patients more choices can help protect more people from cervical cancer.
If you care about cancer, please read studies that a low-carb diet could increase overall cancer risk, and vitamin D supplements could strongly reduce cancer death.
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