Self-Collected HPV Testing Reaches Patients Missed by Routine Screening

Timely cervical cancer screening prevents progression from persistent high‑risk human papillomavirus (HPV) infection, yet many adults marginalized from care do not complete routine exams. People with opioid use disorder are both more likely to be unscreened and face higher risk factors for the disease. Reaching these groups outside traditional gynecologic settings remains a critical gap. New findings demonstrate that offering HPV self-testing within an opioid treatment program increased screening uptake and uncovered more high‑risk results.

UW Medicine evaluated human papillomavirus (HPV) self-testing, using a patient‑collected vaginal swab, implemented at We Care Daily Clinics, an opioid treatment program that provides holistic care. The initiative sought to extend screening access for patients who often go without routine preventive services. The work focuses on detecting high‑risk HPV strains associated with cervical cancer.

During annual wellness visits, the team offered testing to everyone 25 years or older who had a cervix and was overdue for screening or unsure of the date of their last screen. Instead of a pelvic exam, patients self‑collected a vaginal swab to screen for high‑risk HPV. The approach was described as just as accurate as a clinician‑administered screen, feasible in locations without gynecological services, and more comfortable for many patients. Positive results led to follow‑up evaluations that included a Pap smear or colposcopy.

In this setting, the researchers found that 90% of patients were due for screening and, among those, 90% opted to self‑screen. The patient‑collected swabs produced nearly double the rate of high‑risk HPV positivity compared with findings from a recent large cervical cancer screening study conducted in Washington. The process was straightforward for clinic staff and patients, though connecting individuals with follow‑up care remained challenging.

Findings were published in July in JAMA Network Open. UW Medicine collaborated with We Care Daily Clinics to deliver the service. The researchers characterized offering self‑testing in the clinic as an important first step to expand screening and noted that arranging follow‑up care continues to be a key challenge. The team hopes the service will expand to more opioid‑treatment programs and clinics serving underscreened populations, such as farmworkers and unhoused people.

“We have to get out into new environments to reach patients who are not being reached through standard testing,” said Elizabeth Swisher, a professor of gynecologic oncology at the University of Washington School of Medicine and the study’s lead author.

“Screening the unscreened will make an impact on cervical cancer mortality,” Swisher said.

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