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The American Cancer Society now includes self-testing as a recommendation for HPV tests that screen for cervical cancer.
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Doctors in Tarrant County have a new tool that could increase screening for HPV in patients: self-testing.
The American Cancer Society recently released guidelines recommending self-testing for HPV, allowing people to collect a sample from their cervix themselves instead of having a doctor or nurse collect it. Experts say self-collection could increase HPV screening rates and help detect cervical cancer earlier.
“Any way that we can increase screening by lowering the barriers to screening is going to be very important,” said Dr. Andrew Wolf, a UVA Health physician who co-authored the new guidelines. “And one way to do that is have women self test.”
HPV is the most common sexually-transmitted infection in the U.S., according to the U.S. Centers for Disease Control and Prevention.
HPV can cause cervical cancers, anal cancers, throat and neck cancers, vaginal cancers, vulvar cancers and penile cancers. About 13,000 people get cervical cancer each year, and 4,000 die, according to the CDC, despite vaccines that prevent most types of HPV and cervical cancer screening.
“This is not acceptable,” Wolf said. “This is a preventable cancer. We can do better if we follow these guidelines and get our children vaccinated.”
The HPV vaccine protects against two strains of the virus that cause about 70% of cervical cancers, said Dr. Dustin Manders, gynecologic oncologist with Texas Oncology. That means that even if you’re vaccinated, you still need to get screened, said Manders, who is also on the medical staff at Texas Health Presbyterian Hospital Flower Mound.
“Just because you get the HPV vaccine doesn’t sort of get you off the hook,” he said. “There are still the other 30% of cervical cancers that come from other HPV strains.”
Today, most cervical cancer screening is done via either an HPV test or a Pap smear.
Screening for cervical cancer led to a dramatic drop in cervical cancer rates since the 1950s, said Jane Montealegre, an associate professor of behavioral science at University of Texas MD Anderson Cancer Center, but that progress has stalled.
Today, there are disparities in who gets screened for cervical cancer. Women living in rural areas, who are uninsured or who otherwise have less access to medical services are less likely to be screened, Montealegre said.
Self-testing may make cervical cancer screening more palatable for patients who have been through trauma or who feel uncomfortable with a healthcare worker doing the test, experts said.
The self-test is similar to a COVID test, Montealegre said. In research studies, more than 95% of women report that the test is easy to use and that they’re able to follow the instructions accurately.
The Food and Drug Administration has approved self-testing only in a healthcare office setting, meaning that patients can’t yet self-test at home. Once self-testing at home becomes available, experts said screening rates could improve dramatically.
Montealegre conducted a research trial in Houston where some of the participants were mailed an HPV self-collection kit, while others received a phone call that told them to come in and see their provider for an HPV test. There was a 2.5-fold increase in screening when kits were sent to women’s homes, Montealegre said.
“Home-based self-collection really is what we’re all waiting for,” Montealegre said.
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Ciara McCarthy
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