Salir
Scientific breakthroughs in cancer screening have saved many lives. Deaths from cancer in the United States have gone down a lot in the last 50 years, and screening is a big reason for the drop.
But sometimes the biggest barrier to progress isn’t scientific knowledge. It’s what people have to do to get screened.
Take cervical cancer. There are several ways to help prevent cervical cancer. One way is to find and remove abnormal cells. These cells are caused by certain strains of the human papillomavirus, or HPV, and can turn into cancer over time.
But recently, cervical cancer screening rates have declined.
Hereditary cancer risk
Mandelsberg’s path to joining Kaiser Permanente started when she was visiting her father in Israel. He was sick and had learned he had a BRCA gene mutation. Being of Ashkenazi Jewish descent, he urged his 3 daughters to get tested for the gene mutation.
Everyone carries the BRCA gene. BRCA mutations significantly increase a person’s risk for certain cancers, including breast and ovarian cancer. It’s estimated that 1 in 40 Ashkenazi Jewish women has a BRCA gene mutation.
Mandelsberg believes her father’s request saved her life. After his death, she returned home and met with a geneticist at Kaiser Permanente. While still processing her grief, she learned she also had a BRCA mutation.
An MRI showed that she had an aggressive tumor. At age 38, Mandelsberg hadn’t planned to start breast cancer screening for another 2 years. “My story would have been very different if I had waited,” she said.
Barriers to cancer screening
One in 4 women don’t receive regular HPV screenings. And half of all diagnosed cervical cancers occur in people who are not screened.
There are several reasons why people miss these exams.
Some say they don’t have time or transportation. Others say the exams are uncomfortable or embarrassing. Also, pelvic exams can upset people with past trauma.
Researchers at the Kaiser Permanente Washington Health Research Institute asked if more people would get screened if testing was more convenient.
Their findings could change cancer screening for patients everywhere.
Testing for HPV at home
Kaiser Permanente has already boosted colorectal cancer screening rates among our members. Mailing at-home tests to people due for screenings was key to that success.
Our researchers designed a similar program for cervical cancer to see if home tests could increase screening rates.
The research study included 16,590 people from 30 to 65 years old. We sent participants home kits to get a sample swab.
They returned their kits to our labs and the samples were tested for the HPV strains most likely to cause cervical cancer. People received their results, and any necessary follow-up care, just like patients screened in one of our clinics.
Mailing HPV kits increased screening by more than 50%.
And our research showed that samples collected at home detect HPV just as well as samples collected by a clinician.
Improving at-home HPV testing
A follow-up survey showed that people who returned the kits had a very positive experience.
Some people who didn’t return the kits said they didn’t know how to use them. Others said they didn’t want to insert the swab or felt embarrassed to use the kit.
Our team is working to address these issues in a study of 33,000 people.
The study is looking at different ways to reach people based on their previous experiences with screening. It also asks if different kinds of information included with the test kits can motivate people to get screened.
The future of at-home HPV tests
At-home HPV tests are available now in several countries. But in the U.S. they haven’t been approved by the U.S. Food and Drug Administration. Research at Kaiser Permanente and other institutions could help pave the way for their approval in the United States.
At-home HPV testing kits would give people a more convenient choice for early detection of cervical cancer.
For some people, that choice could save their lives.
Learn more about cancer care at Kaiser Permanente.