In BD’s newest global survey, women reported self-collection would motivate them to have regular cervical cancer screening.

By Chris Wolski

In time for Cervical Cancer Awareness Month, BD, a global medical technology company, has released the results of its global survey examining women’s knowledge of and access to routine cervical cancer screening. The survey, which polled more than 2,000 women in the U.S., U.K., and Sweden, found that there was an alarming rate of both misinformation about and barriers to cervical health screenings.

Jeff Andrews, MD, FRCSC, a board-certified OB-GNY who serves as VP of medical and scientific affairs at BD, told CLP that the countries chosen to survey were deliberate—reflecting both the level of public funding and access to health care screenings. Specifically, Sweden was chosen because there is a robust national screening program in place, and the U.K. is also heading in that direction. The U.S. does not have a national cervical cancer screening program. 

In fact, about 30% of U.S. women are either under screened or not screened at all for cervical cancer, according to Andrews. And of the 70% who do receive regular screening, about 25% of those only receive PAP smears alone and no HPV screening. HPV is the cause of virtually all cervical cancers.

Access, fear, and embarrassment are among the reasons women in all three countries cited for not being screened. 

Interestingly, even with the national program, 62% of women in Sweden reported that they didn’t know how often they should be tested compared to U.S. women (51%) and women in the U.K. (43%).

Self-Collection and Cervical Cancer Screening

One answer to the lack of screening and access is self-collection. The survey found that most women (70% U.K., 69% Sweden, and 66% U.S.) would be interested in at-home screening for HPV or cervical cancer because it is more comfortable, less embarrassing, and more convenient. At 42% U.S. women were twice as likely as women in Sweden (25%) and women in the U.K. (15%) to want an at-home test because it was less expensive. This could reflect the nature of medical insurance in the individual countries. 

Andrews sees leaning into self-collection as having another positive.

“Self-collection will help raise awareness,” he says. 

However, could self-collection, while increasing the potential for awareness and access, lead to false positives? Andrews’ answer is a firm “no.”

BD’s self-collection test, for example, comes in sterile packaging and is designed to capture DNA, which is nearly impossible to contaminate. The company has internal controls for human DNA to spot any anomalies. The likelihood of an incorrect test due to poor self-collection is low, says Andrews.

Even with self-collection taking center stage, Andrews says women still decline self-collection of their cervical samples, opting instead for a health care professional to do it. That’s fine with Andrews.

“We don’t mind how we get the sample, we just want women to be screened,” he says. 

Clinical Laboratories and the Future of Self-Collection

While the U.S. is lagging behind other parts of the world in self-collection; currently there are no FDA-approved self-collection tests for HPV, Andrews says that clinical labs need to be prepared for the inevitable—self-collection is on the horizon.

He points to an NIH grant—of which BD is a participant—and the Cancer Moonshot program that are both studying the efficacy of self-collection for cervical cancer screening.

Andrews notes that many labs already have the capability to process HPV tests, but need to look at how they are handling them, particularly at a business level. Because of the high interest at the governmental level, he advises that labs begin preparing for the processing of at-home self-collected cervical samples now. 

Chris Wolski is the chief editor of CLP.