Getting screened for cervical cancer is getting easier and more convenient for members.
That’s a result of innovative approaches allowing members in certain locations to screen themselves at home or in a Kaiser Permanente lab, without the need for an appointment or a pelvic exam.
“It’s just as accurate as screening in the doctor’s office,” said Tracy Seo, MD, regional director of cervical cancer and breast cancer screening. “There are a lot of reasons people don’t get screened. They don’t like the pelvic exam, they don’t like coming to the doctor’s office, they can’t take time off work, they don’t have transportation to get to the exam. These self-screening options make screening more accessible to patients and are more convenient.”
Since 2021, Kaiser Permanente has screened members age 25 to 65 for human papillomavirus, or HPV, as a way to detect early cervical cancer and precancerous changes that can be treated before they develop into cancer. (A pap smear, which collects cervix cells, is recommended for those ages 21 to 24.) Starting at age 25, American Cancer Society considers HPV screening the preferred method. Screening is recommended every 3 to 5 years.
While not yet widely available in the United States, self-collection for cervical cancer screening has been used in several other countries for more than 10 years. In its most recent draft recommendations, the United States Preventive Services Task Force endorsed self-collected HPV tests with the understanding that it’s comparable in accuracy to clinician-collected samples. The medical community is hoping self-collection can increase screening rates.
Kaiser Permanente already has strong cervical cancer screening rates, currently capturing 84% of members who are due for it, Dr. Seo said. The rate of cervical cancer among Northern California Kaiser Permanente members is also lower than the national average, largely due to both high screening and HPV vaccination rates.
Testing cervical cancer screening options
These new screening options are being tested in certain parts of Northern California. The at-home screening, in which a member collects a sample and then mails it to Kaiser Permanente — as members do for colorectal cancer — was piloted last fall to members in the Roseville and Sacramento service areas who were overdue for their screening.
During the pilot, Shavon Lynch, director of Obstetrics and Gynecology/Women’s Health Services, tested the home screening option herself because she was due for it, and she wanted to experience it, especially as her department was making it available for the first time.
“Overall, the experience was great,” she said. “Sure, it did beat having to take time out of my busy day to schedule my cervical cancer screening, an appointment most women don’t love anyway.”
The pilot is expanding to more members now, and it is also extending to members in the Greater Southern Alameda Service Area this fall. Also launching this fall is a pilot of self-collection screening at a Kaiser Permanente lab. Similar to how members come into a lab for a urine analysis, members will be able to screen themselves at the Santa Clara lab.
The self-collection method involves simply swabbing the vagina with a cotton swab.
“It’s very easy to do,” said Betty Suh-Burgmann, MD, clinical lead for the HPV self-screening initiative. “There is no need to aim for the cervix because if HPV is present, it is detectable in the vagina as well.”
The self-collection method had positive feedback from people who tried it last year.
“People really appreciated the ability to be screened in this way,” Dr. Suh-Burgmann said. “Patients want to do the right thing for their health, and this makes it easier for them to do that.”
