Self-Collection HPV Tests Significantly Increase Cervical Cancer Screening Rates

Recent research conducted by the University of Texas MD Anderson Cancer Center has revealed that mailed self-collection tests for human papillomavirus (HPV) have more than doubled participation rates in cervical cancer screenings among women who have never been screened or are inadequately screened. This study, published in JAMA Internal Medicine, marks a significant advancement in cervical cancer prevention strategies.

The study, known as the PRESTIS trial, involved a randomized approach where nearly 2,500 women aged 30 to 65 from the Houston area participated between February 2020 and August 2023. Notably, a majority (94%) of the participants were from ethnic and racial minority groups, with 56% relying on publicly funded health programs.

Results indicated that 41% of women who received self-collection kits along with a phone reminder engaged in cervical cancer screening. In contrast, only 17% of those who received a phone reminder without the self-collection kit participated. The introduction of patient navigation support alongside the self-collection tests and phone reminders further enhanced participation rates, increasing them to 47%.

Lead researcher Jane Montealegre emphasized the importance of these findings, particularly for women who are uninsured, reside in rural areas, or belong to marginalized communities. The study suggests that self-collection HPV testing could be an effective solution to improve access to essential cervical cancer screenings and ultimately reduce the disease's impact in the United States.

In May 2025, the Food and Drug Administration approved the first at-home cervical cancer screening test, which is particularly significant given that approximately 13,000 women are diagnosed with cervical cancer each year. Despite declines in cervical cancer rates due to HPV vaccinations and in-office screenings, significant disparities persist, especially affecting women of color and those living in rural or low-income regions.

Throughout the PRESTIS study, participants were assigned to one of three intervention strategies: a phone reminder for traditional clinic-based screening, a phone reminder coupled with a mailed self-collection test, or a phone reminder combined with both a self-collection test and patient navigation. Data on screening participation were collected six months after these interventions.

Remarkably, over 80% of women who received the self-collection kits returned them, indicating a strong preference and suitability for this method among the participant group. Montealegre highlighted the necessity of gathering data to guide the rollout of self-collection tests, ensuring they are accessible in healthcare settings that cater to populations facing significant barriers to healthcare access.

The research team aims to continue studying the integration of self-collection HPV tests across various primary care environments. However, the study faced limitations, including the potential impact of the COVID-19 pandemic, unclear reasons for participation refusal, and logistical challenges related to mailing kits to participants. Additionally, the trial did not investigate the follow-up care required for patients who tested positive for HPV.