Recent approvals of at-home self-collection tools have expanded options for cervical cancer screening, but a new study suggests many Americans still prefer the traditional clinical setting. Researchers at the University of Texas MD Anderson Cancer Center found that over 60% of women surveyed preferred to have their cervical cancer screenings performed by a healthcare professional in a clinic.
The study, published in JAMA Network Open, also revealed disparities in preferences. Individuals from marginalized groups were more likely to favor at-home self-sampling, while those with lower incomes and those who reported distrust of the healthcare system were more likely to be unsure which option to choose. Of the 2,300 women eligible for screening, only 20.4% expressed a preference for at-home cervical cancer screening, and 18.8% were undecided.
“Home self-collection has the potential to remove many barriers women face to getting screened for cervical cancer. By expanding screening options and pairing them with targeted education, we can empower more women to participate in screening in a way that fits their lives.”
Sanjay Shete, Ph.D., chief of division, cancer prevention and population sciences
Is There Still Value in Offering At-Home Collection Tools?
While cervical cancer screening rates have increased over the past 25 years, there has been a recent trend toward decreased annual screening coverage since the onset of the COVID-19 pandemic. Experts maintain that improving cervical cancer screening among under-screened populations remains a priority, and this study suggests that these groups may benefit from options that align with their preferences.
The study found that Black women were less likely than White women to prefer at-home self-sampling over in-clinic testing. Conversely, individuals who were overdue for screening were most likely to prefer at-home kits, as were those who had experienced bias or discrimination when seeking medical care. The most frequently cited reasons for preferring at-home self-sampling were privacy (54.9%), time constraints (35.1%), and avoiding discomfort (33.4%).
Both the Health Resources and Services Administration and the American Cancer Society have endorsed at-home self-collection for cervical cancer screening.
“Major medical and public health organizations should consider updating their recommendations to include home self-sampling. This policy shift could play a critical role in reducing disparities in screening and improving participation among historically underserved populations,” said co-author Joël Fokom Domgue, MD, principal investigator in epidemiology.
How Was the Study Conducted?
This cross-sectional study utilized data from the 2024 Health Information National Trends Survey (HINTS), a nationally representative survey of U.S. Adults in the civilian population. The study included all women aged 21 to 65 who responded to the survey and were eligible for cervical cancer screening according to the U.S. Preventive Services Task Force guidelines. Participants also had to have answered questions regarding cervical cancer screening.
The study authors acknowledged several limitations. These include the cross-sectional nature of the HINTS data, a lack of familiarity among participants with the newer at-home screening kits, and the fact that the Food and Drug Administration had not yet approved a self-collection tool at the time the HINTS survey was conducted. Data on screening history were also not collected as part of HINTS.
Cervical cancer is largely preventable through regular screening. The standard screening process typically involves a Pap test and/or an HPV test, which can detect precancerous changes in the cervix. Early detection is crucial, as precancerous changes can be treated before they develop into cancer.
The availability of at-home self-sampling kits represents a significant advancement in accessibility, particularly for individuals who face barriers to traditional healthcare access. These barriers can include geographic limitations, lack of transportation, financial constraints, and fear or distrust of the medical system. However, the study findings underscore the importance of understanding individual preferences and addressing concerns about privacy, comfort, and accuracy.
The researchers emphasize that expanding screening options should be coupled with targeted education to ensure that individuals are informed about the benefits and limitations of both in-clinic and at-home screening methods. This education should also address any concerns about follow-up care and the importance of maintaining regular contact with a healthcare provider.
the goal is to increase cervical cancer screening rates across all populations and reduce the incidence of this preventable disease. By offering a range of screening options and tailoring education to meet individual needs, healthcare providers can empower women to take control of their health and make informed decisions about their care.
