Mailing HPV self-test kits to patients is an effective way to screen for cervical cancer, and now new research finds it’s also a cost-effective alternative to in-clinic screening.
Led by a team at Kaiser Permanente Washington and the University of Washington School of Public Health, a study published in Jama Network Open shows how a low-tech, affordable intervention can help save lives from cervical cancer.
“It’s encouraging to see that not only is mailing HPV self-sampling kits highly effective in getting people screened, but it was also cost effective and cost saving in some cases,” said Rachel Winer, UW epidemiology professor and one of the researchers of the study. “It’s a simple intervention: just a swab and tube sent by mail to collect a sample. But it’s patient-centered, accurate and convenient.”
Cervical cancer is the fourth most common cause of cancer in women around the world, but it’s largely preventable. Screening tests can identify precancerous changes that are caused by HPV before they develop into cancer. That’s why getting screened at regular intervals is so important. But in-clinic tests require patients to take time off work, potentially secure childcare, and can be physically uncomfortable, so offering another method of screening through at-home self-test kits is an appealing alternative for some patients.
Winer and the Kaiser Permanente research team conducted a randomized clinical trial several years ago amongst 31,000 Kaiser Permanente Washington members ages 30 to 64. They found these at-home tests were effective at increasing cervical cancer screening rates amongst patients. After this, Kaiser Permanente Washington began offering these kits as part of their standard care. The new study used the randomized trial findings to further assess cost effectiveness.
The researchers looked at cost effectiveness in patients who were up to date with their screenings and also in patients who were overdue for screenings. For the patients who were up to date, mailing self-test kits was both cost effective and resulted in cost savings. For patients who were overdue, mailing the kits was cost effective, with either cost savings or low additional costs.
With this new research showing the cost-effectiveness of the tests, clinics may have more of an incentive to adopt these kits into their health care offerings, Winer said. While self-sampling for HPV is common in Europe, the offering is still very new in the U.S. The FDA approved self-test kits in 2024, but Kaiser Permanente Washington is one of the few health care systems in the U.S. that currently offers kits to patients.
“I hope more health systems in the U.S. will recognize the value of offering mailed HPV self-sampling, giving more people access to cervical cancer screening.” Winer said.
The team is now looking into whether self-sampling kits can increase cervical cancer screenings in low-resource health care settings. They are concluding a two-year pilot study in preparation for a four-year clustered randomized trial with dozens of federally qualified health centers (FQHCs) in Washington and Oregon. This new study is leveraging partnerships with FQHCs and Medicaid health plans to offer kits to patients in the clinic and through the mail.
This research was supported by the National Cancer Institute, part of the National Institutes of Health.
The study includes the following authors, who worked at these institutions at the time of the study: Richard T. Meenan of the Center for Health Research, Kaiser Permanente Northwest; Catherine Lacey, of the UW SPH Dept. of Epidemiology; Diana S. M. Buist of the UW SPH Dept. of Epidemiology, Kaiser Permanente Washington Health Research Institute, Data-driven Strategies for Medicine and Biotechnology; Jasmin A. Tiro of the Dept. of Public Health Sciences, University of Chicago Biological Sciences Division; John Lin of the UW SPH Dept. of Epidemiology; Melissa L. Anderson, of the Kaiser Permanente Washington Health Research Institute; Beverly B. Green of Kaiser Permanente Washington Health Research Institute, Washington Permanente Medical Group, and the Dept. of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine; Rachel L. Winer of the UW SPH Dept. of Epidemiology and Kaiser Permanente Washington Health Research Institute.
Learn more: UW research finds that mailing HPV test kits directly to patients increases cervical cancer screening rates