Summary: BD (Becton, Dickinson and Company) received FDA approval for women to self-collect vaginal specimens for HPV testing, expanding access to cervical cancer screening.

Takeaways:

  1. Increased Accessibility: Self-collected HPV testing can be done in various clinical settings, including pharmacies and mobile clinics, improving access for women facing barriers to traditional screening.
  2. Enhanced Participation: The option for self-collection can lead to higher screening rates, particularly among underserved populations and women who are uncomfortable with pelvic exams.
  3. Improved Detection: The BD Onclarity HPV Assay provides precise results by identifying individual HPV strains, aiding in accurate risk assessment and targeted treatment.

BD (Becton, Dickinson and Company), a global medical technology company, announced U.S. Food and Drug Administration (FDA) approval for the use of self-collected vaginal specimens for human papillomavirus (HPV) testing when cervical specimens cannot otherwise be obtained. The approval allows women to self-collect vaginal specimens for HPV testing in a health care setting, which could include non-traditional locations such as a retail pharmacy or mobile clinic.

HPV is the cause of virtually all cervical cancer, and HPV testing is the preferred screening method by the American Cancer Society in the United States. The BD Onclarity HPV Assay is FDA-approved for HPV primary testing without the need for a traditional Pap smear performed with a speculum. This new approval of self-collected samples opens the door to a less invasive testing option, and it improves access to testing for individuals who face barriers to cervical cancer screening.

“Many patients are uncomfortable with the intimate nature of a pelvic exam,” says Dr. Jeff Andrews, board-certified gynecologist and vice president of Global Medical Affairs for Diagnostic Solutions at BD. “Also, many people live in areas without a local doctor or clinician trained to obtain a sample with a speculum. The option to self-collect in a clinical setting can help women overcome some of these barriers.”

Cervical Cancer is Preventable

Cervical cancer is preventable, and screening plays a crucial role in early detection and prevention. According to the American Cancer Society:

  • Approximately 50% of cervical cancer diagnoses are in never-screened people 
  • 10% of diagnoses occurs in under-screened individuals
  • 25% of women in the U.S. do not receive regular cervical cancer screening

Various factors contribute to inadequate screening, including physical and geographic inaccessibility, financial insecurity (including lack of health insurance coverage), lack of awareness about the importance of screening, social or religious preferences, physical disability, medical conditions, or history of sexual, physical, or psychological abuse that may make a pelvic examination for sample collection by a clinician traumatizing.

Self-Collection Improves Access

Self-collection can improve cervical cancer screening access, especially in underserved populations. In the U.S., Black, Hispanic and American Indian women have higher rates of cervical cancer than women of other racial groups, with Black women having the highest rate of death. With vaginal self-collection as an option for cervical cancer screening, women are more inclined to participate in such care—with never-screened women demonstrating a more than two-fold increase in acceptance and participation—allowing health care providers an alternative option to identify a high-risk HPV infection in more convenient care settings.1,2

Further Reading: How to Close the Gaps in Cervical Cancer Screening

The National Cancer Institute (NCI), part of the National Institutes of Health (NIH), has been working with BD in a public-private partnership called the Cervical Cancer “Last Mile” Initiative to address disparities in cervical cancer screening. As part of this initiative, BD will be a participant in the Self-collection of HPV testing to Improve Cervical Cancer Prevention (SHIP) trial, which will begin enrolling this summer, to evaluate accuracy of self-collection for HPV testing both in health care and other settings, including at home. 

Some HPV Strains Carry a Higher Cervical Cancer Risk than Others

There are many strains (genotypes) of HPV viruses, with some strains posing a much higher risk for causing precancer and cancer than others. BD Onclarity is an FDA-approved assay that reports six HPV strains individually, providing a more precise, accurate way to measure a women’s risk for developing cervical precancer by showing results for an extended set of individual HPV strains and enabling those strains to be tracked over time. Most clinically validated tests report multiple strains in a single pooled result that prohibits monitoring of specific strains over time, which is an important determinant of cervical cancer risk in women who test positive for HPV.

“The integration of self-collection with testing for individualized strains of HPV represents a significant advancement in cervical cancer screening,” says Shieva Ghofrany, MD, a practicing OB-GYN and fellow of the American Congress of Obstetricians and Gynecologists. “Self-collection provides greater access to testing and BD Onclarity allows health care providers to determine the specific HPV strains present in the samples and more precisely identify and treat individuals at high-risk and avoid unnecessary treatments for women at low risk.”

Featured Image: Using a small swab, women can collect their own samples for cervical cancer screening using an HPV test from BD. Photo: COPAN Diagnostics.

REFERENCES

1 MacDonald EJ, Geller S, Sibanda N, et al. Reaching under–screened/never–screened indigenous peoples with human papilloma virus self–testing: A community–based cluster randomised controlled trial.
2  Australian and New Zealand Journal of Obstetrics and Gynaecology. 2020;61(1):135-141. doi:https://doi.org/10.1111/ajo.13285