A large-scale evaluation from Kaiser Permanente Washington suggests that offering patients the option to collect their own vaginal samples for human papillomavirus (HPV) testing can improve cervical cancer screening participation while reducing reliance on clinician-performed pelvic exams.
The findings, published in NEJM Catalyst Innovations in Care Delivery, represent what researchers describe as the first major US health system implementation study of population-based HPV self-collection conducted both by mail and in clinical settings.
Researchers evaluated outcomes among more than 95,000 Kaiser Permanente Washington members ages 30 to 64 who were due or overdue for cervical cancer screening during two separate six-month periods before and after the HPV self-collection program was introduced.
Following implementation, overall cervical cancer screening completion rates increased by an average of 2.2%, according to the study. Screening improvements were particularly notable among Black/African American, Asian, and Hispanic patient populations.
The study also found that clinician-performed pelvic exams for screening declined by more than one-third after the program launched, with 37% of patients completing screening through self-collection methods.
Expanding screening access
Persistent barriers to traditional cervical cancer screening—including discomfort with pelvic exams, scheduling challenges, and limited appointment availability—have contributed to under-screening in some patient populations. HPV self-collection has emerged as a potential strategy to address those obstacles while maintaining access to preventive testing.
“Kaiser Permanente has led the way on this important innovation—first through trials showing that HPV self-collection is an effective and cost-efficient approach to increasing cervical cancer screening, and now by evaluating the adoption of this approach throughout Kaiser Permanente Washington,” said lead researcher Beverly Green, MD, MPH, a family physician and senior investigator with the Kaiser Permanente Washington Health Research Institute (KPWHRI). “The response from clinicians and patients has been extremely positive.”
Clinicians participating in interviews and site visits reported broad support for the program. According to the researchers, providers said reducing the number of pelvic exams improved appointment access, freed time to address other health concerns during visits, and offered patients a more convenient screening experience.
Follow-up systems remain critical
The evaluation also highlighted the importance of coordinated follow-up infrastructure for patients who test positive for high-risk HPV strains.
Among patients with positive high-risk HPV screening results, colposcopy follow-up rates increased from 50% before implementation to 75.8% afterward. Researchers attributed part of that improvement to a centralized safety-net system designed to support patient outreach and follow-up management.
The study was conducted by the Center for Accelerating Care Transformation (ACT Center), part of KPWHRI and Kaiser Permanente Washington’s Learning Health System Program.
Authors said the implementation model could help guide other health systems considering HPV self-collection programs, particularly around the use of standardized workflows, electronic health record tools, and tracking systems to support quality assurance and continuity of care.
“This is a real-world example of a learning health care system in action,” said senior author Paula Lozano, MD, PhD, co-director of the ACT Center and senior associate medical director for research and translation with Kaiser Permanente Washington. “We are using research evidence to inform implementation, continuously evaluate performance, and iterate to better meet the needs of patients and clinicians.”
Note: This news summary was generated by AI based on a published press release, followed by a review from human editors.
