NIH Leading Study Testing Home Screening for HPV and Cervical Cancer

NIH Leading Study to Test HPV and Cervical Cancer

Charlotte Huff

Kaiser Health News (TNS)

Gently wipe the vagina with a small brush to collect the cells. Then place the swab in the screening kit and mail it.

Supporters believe that such simple tests that can be done at home may help the United States approach the eradication of cervical cancer. Next year, the National Cancer Institute will launch a multisite study involving approximately 5,000 women to assess whether home self-sampling is comparable to clinician screening in the clinic.

This year, nearly 14,000 Americans are diagnosed with highly preventable cancers and more than 4,000 die. Vikrant Sahasrabuddhe, NCI’s Program Director for Cancer Prevention, says women who aren’t insured or don’t have regular medical care are more likely to miss a lifesaving screening. If you can collect vaginal and cervical cells to test for human papillomavirus (HPV), the virus that causes almost all cervical cancer, use a home-based stool sample Women can be screened from home just as they can detect colon cancer. He said.

“What we saw is this persistent group of women who continue to have cervical cancer every year,” said Sahasrabuddhe, who oversees research on HPV-related cancers. “And that number hasn’t really decreased.”

Federal authorities hope the study will quickly follow tests approved by the Food and Drug Administration and become part of the screening guidelines when self-sampling proves effective, Sahasrabuddhe said. .. He said federal authorities would work with companies, academic institutions, and others in public-private partnerships rather than waiting for individual companies doing HPV testing for clinicians to conduct self-sampling studies. NCI staff, who expect to spend approximately $6 million on federal funding, will oversee research data and analysis.

“If every company does their own trial and then their own, it can take years to achieve that,” Sahasrabuddhe said. “We want to accelerate that process.”

HPV self-sampling, which is already being promoted in countries such as Australia and the Netherlands, is one of several approaches pursued by cervical cancer researchers in the United States. Another important strategy involves vaccination of adolescents against HPV transmitted through sexual activity. As of 2018, nearly 54% of girls were fully vaccinated by age 17, and nearly 49% of boys were vaccinated, according to the latest federal data. Countries that have succeeded in reducing cervical cancer-one analysis predicts Australia will be eradicating this disease-emphasizes HPV vaccination of adolescents.

Federal authorities still advise vaccinated women to be tested regularly because the vaccine does not prevent all strains that cause cervical cancer. But persuading some women to come to the office for a medical examination is sometimes a tough sell.

In some cases, access and cost can be a problem. Most insurance plans cover screening and there are also some public programs, but uninsured women who do not know them may have to pay for medical examinations and tests. In addition, women may not always be able to leave work, find childcare, or “have had negative emotions or experiences in the past with pelvic exams,” said Rachel. Professor Winner said. Health researching HPV self-sampling.

According to federal data, about four in five women are regularly screened for cervical cancer, but the incidence peaked around 2000 and has declined slightly since then. This figure, based on the patient’s self-reporting, can be optimistic. Another analysis of the medical records of 27,418 women aged 30 to 65 in Minnesota found that nearly 65 percent were current as of 2016, according to a study published last year in the Journal of Women’s Health. understood.

“Unfortunately, we think our data probably reflects what’s happening in our country’s screening rates,” says Dr. Researcher and Researcher at the Mayo Clinic in Rochester, Minnesota. Kathy MacLaughlin said.

One hurdle to getting screened may be the complexity of the guidelines, McLaughlin said. Screening is not an easy-to-remember annual exam and is done at intervals of one year or longer. Female age can help determine when HPV tests or Pap smears that collect cells from the cervix to look for precancerous changes are recommended by the US Preventive Services Task Force.

“That’s exactly the challenge, how do you remember someone of us doing something every three or five years?” said McLaughlin. “That’s hard.”

NCI has not yet set out on the exact self-sampling approach to use, but this technique requires a woman to insert a small brush into the vagina and spin it several times to collect cells. She then slides the brush onto the sample container containing the stock solution and returns the kit for HPV analysis.

According to a review of a study published in 2018 in the medical journal BMJ, the accuracy of identifying HPV was similar when samples were collected by women at home and by clinicians. Jennifer Smith, a professor of epidemiology at the Gillings Global Public Health School at the University of North Carolina, said urine-based HPV testing is also being considered.

Sahasrabuddhe needs to show female self-sampling comparable to detecting HPV before a company applies for an FDA-approved home test, but not as accurately as when a clinician is involved. It may not be. NCI authorities are still finalizing the details of the investigation. But the plan is to call on four companies that already manufacture HPV tests for clinicians, Sahasrabuddhe said. The two companies will take up a tab on the cost of testing and future fees associated with filing a license through the FDA, he said. Sahasrabuddhe expects the research results to be available by 2024.

Women who test positive for HPV will be tested for abnormal cells and cervical cancer, including biopsies, according to Sahasrabuddhe.

When FDA-approved home tests are developed, it is important that uninsured women and others with no easy access to medical care have these procedures available, Smith said.

“Don’t send random kits to people’s homes. It doesn’t mean that someone will discuss the results and be able to integrate them into your follow-up system.”

Kaiser Health News (KHN) is a national health policy news service. This is an editorial independent program of the Henry J. Kaiser Family Foundation, unrelated to Kaiser Permanente.