(BPT) - Pelvic exams — a traditional method of screening for cervical cancer — aren't possible for everyone.
Some women and people with a cervix have specific reasons — past trauma, pain or discomfort or cultural and religious customs — that make it difficult for them to undergo pelvic exams. This type of exam involves footrests or stirrups and a speculum to obtain cervical cell samples for Pap and HPV tests that are crucial in identifying cancer and precancer.
For other women, there may be physical access barriers. Women who don't live close to an OB-GYN or have easy access to transportation may find it challenging to get to a screening appointment farther away from their home or work.
Last year, the U.S. Food and Drug Administration's approval of HPV self-collection testing in a healthcare setting removed barriers for women by allowing them to take their own vaginal sample for testing without the need for a pelvic exam by a doctor. Nearly all cervical cancer cases are caused by infection with certain strains of HPV.
"Unfortunately, for some women, standard screening just isn't possible for them," said Dr. Carolyn Kay, OB-GYN and Roche Diagnostics medical affairs lead. "As a new and accessible option for regular screening, HPV self-collection can give more women the opportunity to take control of their health and support early detection and treatment. It provides a new way for women to take their health into their own hands — literally — in more accessible and private settings."
Cervical cancer is highly treatable when detected early. Access to timely HPV screening and diagnosis has a significant impact on how many women get cervical cancer and the outcome of the disease, according to clinical studies. More than half the patients diagnosed with cervical cancer in the U.S. have never been screened or have only been screened infrequently, and they do not participate in routine screening, according to a study published in the Journal of Genital Tract Disease.
Some populations are more vulnerable. Compared with non-Hispanic White women, one study showed that Asian and Hispanic women were more likely to be overdue for screening, as were women who lived in rural areas, lacked insurance, or identified as lesbian, gay, bisexual, queer, other or unsure (LGBQ+).
Cervical cancer screening takes place in a couple of different ways. One is called co-testing, which includes Pap testing, an assessment of a sample of cervical cells for cancerous or precancerous changes, and HPV testing, which checks for the presence of high-risk HPV types in cervical cells. The other, called primary screening, is the HPV test only.
About 85% of people will be infected with HPV at some point in their lifetime, though not all strains are high-risk for cancer. Screening guidelines can vary by agency, women's age and testing approach, with most recommending an interval of a couple of years between screenings.
HPV self-collection is an alternative that can help make regular cervical cancer screening more accessible and patient-friendly. Rather than relying on a sample taken by a doctor during a pelvic exam, patients take their own test sample in a healthcare setting.
After receiving instructions from a healthcare professional, women position themselves comfortably in a private space and use an approved device to swab into the vagina a couple of inches to collect a vaginal sample. The healthcare professional then sends the sample to a lab, where it is analyzed using the same test that's used on samples collected by doctors. As with traditional HPV testing, the healthcare professional can follow up with results and, for a positive test, coordinate further testing as needed.
HPV self-collection can help women overcome barriers to screening, especially women who don't screen often or who have never been screened. In addition to providing women with greater privacy and control over the testing procedure, HPV self-collection can be used in a broad variety of settings, such as doctor's offices, clinics and mobile healthcare units.
Regular cervical cancer screenings for HPV are no cost for most under the Affordable Care Act.
