Improving access to HPV testing

Human Papilloma Virus is the cause of about 37,000 cases of cancers every year. 

The virus is largely preventable thanks to vaccines, but many cannot access testing due to geographic, financial, or other reasons. 

Now, a new initiative is aiming to raise awareness and improve accessibility to testing. Here, Diane Harper, M.D., M.P.H. M.S., discusses the initiative and the importance of screening for HPV.

What is the Last Mile Initiative?

The Last Mile Initiative is a partnership through the National Cancer Institutes to assess effectiveness of self-collection based HPV testing for cervical cancer. 

A nationwide trial – called SHIP, short for Self-collection for HPV testing to Improve Cervical Cancer Prevention – is the main tool to assess the change in screening. 

What’s the goal of SHIP?

The SHIP Trial will provide an independent platform to evaluate the usability, acceptability, and accuracy of multiple self-collection device-assay combinations for the detection of cancer-causing types of HPV.

Why is this HPV initiative important?

Fifty percent of women diagnosed with cervical cancer are not detected by screening. Over half of the cancers occur because women do not screen. 

If we had something feasible, pleasant, useable, and empowering for women, they might screen and the cancer could be detected at the pre-cancer stages.

How does this HPV initiative support accessibility in testing?

There’s significant potential to address a persistent cancer health disparity by expanding cervical cancer screening access to those individuals who are never screened or under-screened due to lack of health care access, cultural concerns, or other health inequalities. 

What should patients know about HPV self-testing?

Cervical cancer screening is HPV directed and HPV can be detected through self sampling equally as through a speculum based exam, and it’s just as accurate. 

There’s no reason for a woman without any symptoms to have a speculum exam for her cervical cancer screening. 

Cervical cancer is all about HPV, HPV vaccination helps prevent some cancers, HPV testing detects infection and early changes and cancers.

HPV is in the skin  – no in the semen, or fluids – so it starts in the outside skin to skin contact, and spreads through the vaginal skin to the cervical skin… so sampling the vaginal skin directly or having a urine wash of the vaginal and vulvar skin provides the same dead cells that contain the HPV as the speculum based sampling.