A recent study found that mail-in self-collection HPV tests significantly boosts cervical cancer screening participation among under-screened women, suggesting a promising strategy to improve cancer prevention efforts in underserved communities.
A recent study from The University of Texas MD Anderson Cancer Center reveals that mail-in self-collection HPV tests more than doubled cervical cancer screening rates among never- and under-screened U.S. women. This real-world study, published in the journal JAMA Internal Medicine, offers an innovative pathway to address cervical cancer disparities.
The randomized PRESTIS study showed that 41% of women who received mailed self-collection tests and a telephone reminder participated in cervical cancer screening, compared to just 17% who received only a telephone reminder. When patient navigation support was added, participation rates increased to 47%.
“Too many women, especially those who are uninsured, live in rural areas or come from marginalized and underserved communities, aren’t getting screened for cervical cancer,” lead author Jane Montealegre, an associate professor of behavioral science, said in a news release. “These results show that self-collection testing could be a solution to increasing access to screening and, in turn, reducing the burden of cervical cancer in the U.S.”
The significant finding comes just after the FDA approved the first at-home screening test for cervical cancer in May 2025.
Cervical cancer continues to affect nearly 13,000 women annually in the United States, and while HPV vaccination and in-office screening have lowered overall rates, disparities persist, especially among women of color and those in low-income or rural areas.
Between February 2020 and August 2023, the PRESTIS study enrolled nearly 2,500 women aged 30-65 from the Houston area. A substantial 94% were from ethnic/racial minority groups, and 56% were enrolled in publicly funded financial assistance programs.
The study evaluated three types of interventions:
- A telephone reminder for clinic-based screening;
- A telephone reminder with a mailed self-collection test; and
- A telephone reminder with a mailed self-collection test and patient navigation.
The study found that over 80% of the women who received self-collection tests returned their kits, demonstrating their preference for this screening method. This supports the idea that self-collection tests are more suitable for underserved populations.
“As self-collection tests become available in the U.S., it’s vital that we gather data to guide how they are rolled out. We want to make sure that they become available in clinics and health centers that care for people who often have the hardest time accessing health care,” Montealegre added. “By removing barriers, we are hopeful that we can improve the uptake of evidence-based screening tests and make significant progress against this preventable disease.”
Future research directions will focus on integrating self-collection HPV tests into various primary care settings.
However, the study faced limitations such as the impact of the COVID-19 pandemic, unclear reasons for participation refusal, and challenges in mailing the kits. Additionally, the study did not explore differences in follow-up care for patients testing positive for HPV.