Screening HPV at Home
In Chapter 6 of The Decision Tree, "Screening for Everything", Thomas talks about the human papilloma virus (HPV), the virus that causes cervical cancer. Traditionally, doctors detected HPV by looking for irregular cells in the pap smear. But now, a cheap ($5) test can detect and analyze the DNA of the virus, determining if it is the high- or low-risk type, which can determine the likelihood of a patient developing cervical cancer. One problem remains: you still have to get women into the clinic to be tested. However, a new study in the British Medical Journal shows that home testing is not only a reality, but it may actually boost compliance rates. Roughly 28% of women using the home testing kit, which consisted of a simple cervicovaginal lavage, effectively screened themselves, while only about 17% of women required to go into the doctor's office for screening showed up.
The HPV DNA test is primarily looking for the high-risk virus serotype, and the authors of this study claim that home screening kits have the same sensitivity as the doctor's protocol when specifically looking for the aggressive virus.
Special thanks to Lindsay Crouse for bringing this to my attention. In her email to me, she brilliantly summed up the significance of home HPV testing:
While screening has been tremendously successful in Western countries at reducing cervical cancer cases and deaths, the obstacle of reaching all women through screening remains. Currently, if a woman is to be screened for cervical cancer, she must visit a health care provider for a gynecological exam. If she is unable or reluctant to do that, whether due to transportation, cost, or comfort issues, she is less likely to get screened at all, and is consequently at increased risk for developing cervical cancer. More than half of such cancers are typically diagnosed in women who do not get screened regularly.