Issue link: https://viewer.e-digitaledition.com/i/1361647
Self-Screening for Human Papillomavirus RESE ARCHERS AT THE UNIVERSIT Y OF WA SHINGTON AND FOUR OTHER HE ALTH INSTITUTES E XPLORE WHE THER AT-HOME SCREENING TESTS ARE AN EFFICIENT AND EFFECTIVE WAY TO DE TECT CERVICAL PRECANCER. E V ERY Y E A R , A N estimated 12,000 women in the United States are diagnosed with HPV-associated cervical cancer, according to the CDC. Half of these diagnoses are in women who are underscreened. "Pap screening is very effective for reducing cervical cancer incidence and mortality, yet one in four U.S. women are either overdue for routine screening or have never been screened," says Rachel Winer, PhD, Professor of Epidemiology with the UW Department of Epidemiology and Affiliate Investigator at Kaiser Permanente Washington Health Research Institute. "These underscreened women are a high-priority population to get screened." To determine whether mailed HPV self-sampling kits, similar to those used to detect colorectal cancer, would help improve early detection and treatment of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) and increase the uptake of cervical cancer screening, Dr. Winer and her colleagues launched their study, "Effect of Mailed Human Papillomavirus Test Kits vs. Usual Care Reminders on Cervical Cancer Screening Uptake, Precancer Detection, and Treatment: A Randomized Clinical Trial." "Home-based HPV screening can address several barriers to clinic-based screening, including those related to logistics, such as difficulty scheduling, finding transportation or childcare, or taking time off of work, [and] fear of pelvic examinations and prior negative experiences with screening," Dr. Winer says. "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. And randomized trials in other countries have shown that offering home-based HPV testing increases screening participation." London, England-based Belinda Nedjai, PhD, Senior Research Fellow and Director of the Molecular Epidemiolog y Lab at Queen Mary University of London, is one of those international investigators. Together with her team of researchers, Dr. Nedjai developed a noninvasive at-home screening test that would identify cervical pre-cancer through the analysis of urine and vaginal samples. They found that the self-screening tool was popular with women who used the test as part of a study led by Dr. Nedjai, leading the researchers to believe that it was likely to encourage more women to participate in cervica l cancer screening. "To the best of our knowledge, this study is the largest to test a methylation classifier, called S5, in urine and self-collected cervical samples to detect pre-cancer lesions in women who have been referred for further investigation," Dr. Nedjai says in a press release published by the National Cancer Research Institute in London. "We expect the self-sampling test to improve acceptance rates for cervical cancer screening, as well as reduc- ing costs to health services and improving the performance of screening programmes." Investigating the Impact of BY K ATY MENA-BERKLEY 2 4