Mailed self-sampling kits helped more women get screened for cervical cancer

November 06, 2019

Signaling a potential major change in cervical cancer screening options for American women, a new study found that mailed self-sampling kits that test for HPV -- the virus that can cause cervical cancer -- helped significantly more women get screened for the cancer.

The study involving nearly 20,000 women was conducted by researchers from the University of Washington and Kaiser Permanente Washington Health Research Institute and was published Nov. 6 in JAMA Network Open.

In the study, women within the Kaiser Permanente Washington system who hadn't been screened for cervical cancer in more than three years were randomized into two groups: Roughly half were mailed an HPV self-sampling kit that they could complete as an alternative to Pap screening, and the other half received only the standard care reminders to be screened in a clinical setting.

Within the cohort of underscreened women in the self-testing arm of the study, 26% were screened for cervical cancer versus 17% of underscreened women who received the standard reminders. Of those underscreened women who returned the kits, 88% tested negative for the virus, signaling low risk for cervical cancer.

"Many studies have shown that an HPV test on a sample that a woman collects for herself performs as well as an HPV test done on a physician-collected sample," said lead author Rachel Winer, professor of epidemiology at the UW School of Public Health and affiliate investigator at Kaiser Permanente Washington Health Research Institute. "Randomized trials in other countries have shown that offering home-based HPV testing increases screening participation, but this was the first U.S. trial to study the impact of mailed kits in a real-world health system setting."

Half of the 12,000 cervical cancers diagnosed annually occur in women who have gone longer than three years without a screening, according to previous studies. That makes these women a high-priority population to get screened, the researchers said.

"We found that mailing unsolicited self-collection kits for HPV testing increased cervical cancer screening by 50 percent in women who were underscreened for cervical cancer, and that's a particularly hard population to reach," said co-author Diana Buist, senior investigator and director of research and strategic partnerships at Kaiser Permanente Washington Health Research Institute.

"So, it's a good news story," Buist said. "And now that HPV-only testing is a recognized screening strategy in the United States, it really opens up the possibility for home testing to be a widespread option for women."

Researchers also wanted to find out whether this high-priority population of women would perform the self-sampling and then, if the sample tested positive for HPV, go in for a follow-up test to determine the presence of precancerous cervical cells that could be treated to prevent cancer.

Unfortunately, they noted, while the vast majority of women tested negative for the virus, not all of the participants who tested positive followed up.

"It's great that 88% of women who self-sample at home would not need to come into the clinic," Winer said, "but there's a key 12% in our trial that were identified to be at increased risk for cervical cancer -- and yet only 70% of those women came in for follow-up testing."

Consequently, the researchers said, additional implementation efforts need to strategize how to increase use of the kit and in-clinic follow-up for positive results to maximize detection and treatment of pre-cancers in high-risk women.

"The landscape of cervical cancer screening in the U.S. is changing, and there is a real opportunity to expand options and improve the screening process for women," Winer added. "I'm hopeful that a few years down the line, home-based screening will become routinely available."
-end-
Co-authors include John Lin, research study coordinator at the UW Department of Epidemiology in the School of Public Health; Jasmin Tiro, associate professor at the University of Texas Southwestern Medical Center; Diana Miglioretti, senior investigator at Kaiser Permanente Washington Health Research Institute and professor at University of California, Davis; Tara Beatty, project manager at Kaiser Permanente Washington Health Research Institute; Hongyuan Gao, programmer at Kaiser Permanente Washington Health Research Institute; Kilian Kimbel, research specialist at Kaiser Permanente Washington Health Research Institute; and Chris Thayer, chief medical information officer at Kaiser Permanente Washington.

This research was funded by the National Cancer Institute of the National Institutes of Health.

Grant: R01CA168598

For more information, contact Winer at rlw@uw.edu or 206-616-5081

Pronunciation:

Rachel Winer -- RA-chull WINE-er

Diana Buist -- DI-ANNA BUSED (like fused)

Social media: @uwsph @uwepidemiology @dianabuist @kpwashington @KPWaResearch

University of Washington

Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.