At-Home Tests Identified 12.4% of Women with High-Risk HPV

HPV home tests only require a swab sample collected from inside the vagina

Screening women for the human papillomavirus (HPV) is a promising way to help detect potential cervical cancer earlier in life, said researchers from The Ohio State University (OSU). 

This OSU study concluded that mailing at-home HPV tests to hard-to-reach women may be a viable approach to increase cervical cancer screening where access to women’s healthcare may be limited. 

Cervical cancer is a very slow growing disease. And if caught early is almost always treatable. 

However, most women do not have symptoms.

And, finding out whether or not you have HPV is an important step in preventing and treating cervical cancer. 

But, many at-risk women go without HPV screening and without Pap Tests that look for abnormal cells on the cervix. 

A Pap Smear requires that you go to your healthcare provider’s office and receive a speculum exam. 

While an HPV test only requires that a swab sample is collected from inside the vagina, close to but not in the cervix. The sample is then screened for high-risk strains of HPV that can cause cervical cancer. 

About half of the 193 women in this study, called the Health Outcomes through Motivation and Education Project, had not been screened for cervical cancer through Pap testing in more than five years. 

The study, which appears in the journal Sexually Transmitted Diseases, found that 78 percent of women who received the at-home test kits used them, and sent the test kits back to the researchers for testing. 

Women who sent in an HPV test were notified that their results were available and advised to make an appointment with their local health center to receive their results. 

Overall, 193 women had conclusive results for all 3 samples and cytology results. 

Prevalence of high-risk HPV within self-home samples (12.4%) was not different from that within clinician samples (11.4%), and from that within self-clinic samples (15.5%). 

And, (93.6%) of the participants reported no difficulty understanding self-collection instructions. 

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In the OSU study, only 11 percent had a follow-up Pap test to screen for cervical cancer, and Pap testing was most common among those women with high-risk HPV types detected in their sample. 

“The return rate was so much higher than we expected based on experiences in other countries,” said Paul Reiter, an associate professor of health behavior and health promotion at Ohio State, said in a press release.   

“There’s a lot of interest in exploring more widespread use of these tests in the U.S., particularly to increase screening rates among women who aren’t getting regular care,” said Reiter, who is part of the cancer control research program at Ohio State’s Comprehensive Cancer Center (OSUCCC).   

HPV is a very common virus; about 1 in 4 adults are infected with a cancer-causing type of HPV, according to data from the US Centers for Disease Control and Prevention (CDC), which collaborated on this OSU study. 

Most HPV infections clear without causing health problems, but in some cases, they lead to cancer of the cervix, vulva, vagina, penis, anus or throat. 

Almost all cervical cancers are caused by persistent HPV infection, says the CDC. 

Current CDC screening guidelines call for a combination of Pap testing and HPV testing every five years for women 30 to 65 years old and for Pap testing alone every three years for women 21 to 29 years old for low risk women.

The researchers partnered with federally qualified health centers in southeast Ohio to identify the women in the study, which was co-led by Mira Katz, a professor of health behavior and health promotion and a researcher with the OSUCCC. 

“We appreciate the importance of figuring out how to get these women to come to the clinic.” 

“One of the things that we would need to think about moving forward with our research is minimizing the drop-off rate,” Reiter said. 

These at-home HPV tests are widely used in other countries, such as: 

  • In two large studies in the Netherlands, each among over 25,000 women who had not responded to invitations and reminders for an in-clinic visit and Pap test, one-third of the women did return a self-sampling device when provided with the option (50, 51),
  • In a study of over 3,000 Norwegian women, offering self-sampling materials instead of an invitation for a physician-sampling visit increased attendance to 33.4 from 23.2% (52),
  • A study performed among 4,060 Swedish women who had not been screened in at least 6 years, 39% accepted an invitation for self-sampling and HPV testing, while only 9% accepted an invitation for a Pap smear (53).

Other Ohio State researchers who worked on the study were Abigail Shoben and Electra Paskett. 

Funding came from the National Cancer Institute and from Pelotonia, a grassroots cycling event that has raised more than $184 million for cancer research conducted at Ohio State.