Cervical cancer self-collect screening could be a game changer for healthcare access

Scientists at the Masonic Cancer Center (MCC), University of Minnesota have been leading the way in groundbreaking research to improve cervical cancer screening. Our team of doctors, nurses, scientists, and educators at MCC is committed to reducing the burden of cancer on Minnesotans and beyond by advancing knowledge and enhancing care. With about half of all Minnesotans projected to be diagnosed with cancer at some point during their lifetime, our work is crucial for everyone who calls our state home.

For over 10 years, Dr. Rebekah Pratt, co-associate director of community outreach and engagement at the Masonic Cancer Center, has been collaborating with Imam Sharif Mohamed and Mr. Wali Dirie at the Islamic Civic Society of America (ICSA). Together, they have been working to improve access to cancer screening that can better meet the needs of the Somali American community. One issue that the community was particularly concerned about was cervical cancer screening. Only around 25-50 percent of Somali Americans are up to date with cervical cancer screening, compared with around 75 percent of the general population.

“Islam teaches a person to see their mind, body, and soul in a holistic way and keep that in balance,” says Imam Sharif Mohamed. “Therefore, Islam greatly values prevention and screening. We are really pleased to be collaborating with Dr. Pratt on this project—it is so important to advocate for the needs of our community and find new ways to make screening more accessible to our community.”

Dr. Rebekah Pratt, along with Dr. Rachel Winer at the University of Washington, Seattle, in partnership with Imam Sharif Mohamed at ICSA, have been working with three Minneapolis primary care clinics to offer a new way to screen for cervical cancer that does not require a pelvic exam: self-screening. Their research shows that self-screening improves access to cervical cancer screening  for Somali American patients, and they were thrilled to be able to offer this new approach to all patients at the three Minneapolis area clinics that participated in the study: People’s Center Clinic and Services, the Community University Health Care Clinic, and Smiley’s Family Medicine Clinic.

Tim Ramer, medical director at Smiley’s Family Medicine Clinic says about the new screening approach: “I am excited about being able to offer patients cervical cancer self-screening during a follow up visit for routine things like diabetes, or even a cold.  Patients have expressed appreciation to have this [screening] without a pelvic exam." 

Cervical cancer is the fourth most common cancer among women globally, and of the approximately 13,000 people diagnosed in the U.S. each year, at least half are overdue for screening or have never been screened. There can be barriers to having cervical cancer screening, including not being very familiar with cancer or cancer screening, poor access to healthcare, upsetting prior experiences of cervical cancer screening, or cultural norms that aren’t supportive of screening. Despite those concerns, on-time screening is crucially important for prevention and early detection—and can be lifesaving.

Ann Rogers, chief executive officer for People’s Center Clinic and Services, says about the new screening approach: “We are excited to offer the HPV cancer screening to women and foster an early and easy process. The HPV self-collect process is an innovative asset to cancer screening and early detection. It is important to get screened early because early detection leads to better success rates and overall healing. The HPV self-collect approach is one catalyst that leads to a shift in how women take care of themselves.” 

When people are screened for cervical cancer, it is typical to have what is called a Pap test, which involves looking for precancerous or cancerous cells, alongside a test for the human papillomavirus, or HPV. HPV testing alone, also called primary HPV testing, is increasingly being used as a standard, highly effective screening approach for cervical cancer. Primary HPV testing can now also be offered as a self-collected test in the U.S., putting screening directly into the hands of patients. 

In May 2024, the U.S. Food and Drug Administration (FDA) approved these self-collected HPV tests to be offered in healthcare settings, providing an alternative for people who have been previously reluctant to screen, or who would prefer to take their own test. Previous research has shown that patients generally felt very positive about taking their own samples, and that it could help with reaching more individuals to take part in cancer screening.

The research conducted by Drs. Pratt and Winer is called the Isbaar Project and was funded in 2021 by the National Institutes of Health to see if cervical cancer screening rates could be improved by offering HPV self-collected testing in primary care clinics. The study found that screening rates increased by over 12 percent, and for some sub-groups, such as Somali American patients, the increase was as much as 14 percent! This was one of the first times in the U.S. that clinics were routinely offering this new option to their patients. The study also found that offering HPV self-collection was positively received by patients and providers alike. 

Dr. Roli Dwivedi, MD, chief executive officer and chief clinical officer at partner clinic CUHCC says about the new testing option: “At the Community-University Health Care Center (CUHCC), we are committed to advancing health equity through rigorous research, collaboration, and meaningful engagement with our diverse community. By engaging in self HPV screening research with Dr. Pratt’s team, we were able to translate community-based research into actionable clinical services. We learned and bridged the gap between scientific discovery and accessible, culturally responsive care, ensuring that our services truly reflect and serve the unique needs of our patients.” 

Clinics across the country are slowly starting to offer HPV self-collection testing, an innovation that may be a game changer for cervical cancer screening, both helping to save lives and to put screening into the hands of patients. Drs. Pratt and Winer hope to share their findings with other clinics and help lead the way in this new cancer screening innovation.

Check out our cervical cancer infographic to learn the most common signs and symptoms of cervical cancer, and consider asking your healthcare provider if the HPV self-collect approach would be a good fit for you. 

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