Screen for cervical cancer at home
At-home cervical cancer screening is giving some women the option to avoid an uncomfortable visit to the doctor’s office. New guidelines from the Health Resources and Services Administration allow some women to self-collect a screening sample at home. Dr. Claire Hoppenot, assistant professor of gynecologic oncology at Baylor College of Medicine and the Dan L Duncan Comprehensive Cancer Center, shares who the at-home test can benefit and when you still need to see a physician.
At-home tests approved by the Food and Drug Administration allow women to swab inside the vagina and return the sample for analysis. “They are testing for human papillomavirus (HPV), which is the cause of 99% of cervical cancer,” Hoppenot said.
During a pap smear at a clinic, the physician will visually examine the cervix for abnormalities. The sample collection includes an HPV swab as well as the pap smear itself, a scraping of cervical cells. A pathologist examines the cells under a microscope for abnormalities. The at-home swab in the vagina does not reach the cervix and is not able to collect the cells tested with a pap smear. However, Hoppenot says the at-home test still is a reliable testing option.
“In screening for cervical cancer, we are relying more and more on the HPV test even before looking at the way the cells look under the microscope because HPV is so strongly associated with precancerous dysplasia and the cancer itself,” Hoppenot said.
Women who test positive for HPV on an at-home test need to schedule a follow-up appointment with a gynecologist. The doctor will examine the cervix for abnormalities and may conduct a colposcopy, a more detailed examination of the cervix with a microscope. They will look for signs of precancer or cancer and may take a biopsy.
“Taking this test at home must come with access to a gynecologic appointment,” Hoppenot said. “If your results are abnormal, you have to follow up with your doctor.”
Hoppenot says that at-home testing can be a great option for women at low risk for cervical cancer, and it can help avoid unnecessary exams.
“Many people get a lot of anxiety in the gynecologist’s office. The pap smear itself is very uncomfortable, more so for some people than others,” Hoppenot said. “The majority of women are HPV negative. This test will allow them to skip the exam if it’s not needed.”
At-home HPV testing is recommended for women between the ages of 30 to 65. Women under the age of 30 are more likely to clear an HPV infection, so pap smears are recommended to look for cervical cell abnormalities. Women should note that the new at-home testing option is only for cervical cancer screening and does not screen the uterus or ovaries.
According to the American Cancer Society, women who are at high risk for cervical cancer, including those with a previous abnormal pap smear or dysplasia and those with immune deficiencies, are not good candidates for at-home testing and should continue to see a doctor for screening.
“Cervical cancer, if detected in the precancerous or early cancer stage, is very treatable. However, advanced cancer is very difficult to treat,” Hoppenot said. “Pap smears and HPV testing do a fantastic job of predicting who is at risk so that we don’t get to the point of cancer development.”
By Molly Chiu
