Progress transformators of early prevention and detection have brought us closer to the elimination of cervical cancer. In addition to being very treatable at early stages, cervical cancer is one of the rare cancers which is largely avoidable thanks to recommended vaccination and screening efforts. The impact of these efforts has been deep because the incidence of cervical cancer and death in the United States fell more than half between the 1970s and 2000s. But we are not yet at the finish line – achieving a future where nobody dies of the disease which will require a continuous dedication to detection, vaccination and a timely treatment for all patient populations. By overcoming the obstacles to access and improving the diagnostic process with innovative screening approaches, we can further reduce the global burden of cervical cancer.
Where screening and prevention efforts failed
Nine of the ten cases of cervical cancer are caused by the human papillomavirus (HPV), making screening and vaccination of HPV against high risk strains some of our most impactful tools to fight against the disease. Between 2008 and 2022, precancerous cervical lesions decreased by 80% in projected women aged 20 to 24, the age group most likely to have been vaccinated against HPV. Despite these impactful results, the absorption of the HPV vaccine remains relatively limited to the United States, with less than two-thirds of adolescents aged 13 to 17 who have received all the recommended doses.
VPH and PAP tests, which can detect cancer or precancerous changes in cervical cells, are essential to identify people at risk of cervical cancer and allow intervention in its first most treatable stages. However, more than half of us, women diagnosed with cervical cancer, have never been detected or have undergone infrequent screening. People diagnosed with cancer at advanced stages also tended to report longer since their last screening.
The differences between certain socio -demographic groups are apparent in cervical cancer screening rates. For example, a 2019 study revealed higher delay rate rates in American women without insurance, those of racial / ethnic minority groups, those who live in rural areas and those who identify as lesbians, gays or bisexuals. A more recent study revealed another disturbing trend: overall cervical cancer screening rates decreased between 2019 and 2022, particularly affected rural women. These gaps in screening align with the differences in incidence and survival of cervical cancer. Black and Hispanic women, as well as women in low -income and rural communities, are the most affected by the disease.
Support the prevention of cervical cancer with accessible and precise screening
Although there is no “magic ball” solution to reduce the load of cervical cancer, the progress that makes regular screening more accessible and adapted to patients are fundamental steps to support early detection for all women. The identification of solutions requires an understanding of the factors stimulating disparities in appropriate testing.
Current PAP and HPV test procedures, which generally require a pelvic examination to allow a health care provider to collect a sample of cervical cells, can be annoying and stressful. For many people, taking and attending a screening appointment is subject to logistical obstacles, the difficulty of taking work on work to a lack of transport. With an average waiting time of more than a month for an OB / GYN appointment in the United States, following screening for cervical cancer can be frustrating or simply inaccessible. The invasive nature of a pelvic examination can also be painful or uncomfortable for many people, especially those with history of sexual trauma, cultural concerns and disabilities.
Overcoming access limited access to cervical cancer screening is a multiple faceted problem, but the new options for the way tests occur are promising steps. The self-collecting tests of the HPV, which allow a woman to independently collect their own vaginal sample in a health care establishment, first received approval from the Food and Drug Administration of the United States in 2024. Development in a new way of obtaining a vaginal sample without using a pelvic examination represents a significant extent of screening, as the tests for CV strains, Providing cancer are now possible health care parameters. Self-collection options allow those who do not want or cannot have a pelvic exam to overcome obstacles to detection of cervical cancer and take control of their health. However, samples tests collected by the clinician remain an option for people who prefer this method or when a pelvic examination is indicated on the basis of reported symptoms.
Other progress in diagnostic technology also supports a more precise evaluation of HPV infection and the risk of cervical cancer. Although HPV tests can precisely identify the high-risk strains of the virus, they do not detect markers from pre-cancer or cancer itself. Double -floor cytology is a recent innovation that provides an objective assessment and based on the biomarkers of the infections with the most likely to progress towards cancer. By detecting the co-expression of P16 and Ki-67 in the same cervical cell, an indicator of active changes mediated by HPV in cells towards preparing it and cancer, double floor tests distinguish clinically significant infections from transitional infections which can be resolved by themselves. This helps clinicians determine patients who need immediate follow -up and can be monitored safely, reducing unnecessary procedures while guaranteeing timely care for those most at risk.
The future of cervical cancer screening
The self-collecting tests of the HPV are about to cause continuous momentum in the fight to eliminate cancer from the cervix. Until now, evidence has demonstrated comparable clinical performance between self-collected samples collected by the clinician for HPV tests, but a more in-depth assessment will be precious to develop best practices for clinical integration. In 2024, the national cancer of the National Cancer Institute “Last Mile Initiative” launched a multisite clinical trial dedicated to the evaluation of the precision, conviviality and clinical efficiency of self-collecting TPH tests for the detection of cervical cancer. The self-collecting testing of HPV tests to improve the prevention test of cervical cancer (ship) will register for participants at 25 various health care sites in the United States to further shed light on the FDA of self-collecting devices. In addition, an update of recommendation from December 2024 of the working group on the preventive services of the United States also stressed the importance of HPV tests and included self-collected HPV tests as part of its cervical cancer screening guidelines.
By expanding access to the detection of cervical cancer, in particular for those faced with obstacles to traditional methods based on clinic, self-color tests of HPV allows more people to participate in their own care, to promote autonomy and to help to fill long-standing gaps in access to projections for all populations. Auto-collects of HPV is improving not only the early detection of high-risk infections, but also aligned with wider public health objectives to eliminate the load of cervical cancer.
As growing evidence supports the accuracy and reliability of self-collecting HPV tests, its adoption in national screening guidelines could help us cross the “last kilometer” of the reduction in the impact and mortality of cervical cancer. The self-color of HPV is more than a practical alternative to traditional test approaches: it represents a new accessible and inclusive screening paradigm. Although there is much more work to do to fight against cervical cancer and overcome persistent disparities for all, diagnostic advances open the way to a healthier and more food future.
Photo: Photographybasic, Getty Images
Carolyn Kay, MD, is an obstetrician-gynecologist by focusing on pre-cancer and cervical cancer, racial disparities in cervical cancer screening, reproductive health and the use of digital technology to meet the unatssed health of women. While global medical affairs direct oncology tests at Roche Diagnostics, it contributes to the global movement to eliminate cervical cancer while working to move the needle on the education of doctors and health literacy in historically excluded communities. Dr. Kay obtained his medicine diploma at the Suny Upstate Medical University and underwent training in residence at Hofstra-Northwell Health in New York.
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