Health and Me

Ishita Srivastava

Cervical Cancer Screening: Clinic vs Home Testing, What Women Prefer | Women's Day

As cervical <a href="https://www.healthandme.com/health/cancer">cancer</a> screenings ramp up across the world, a new JAMA study shows that a majority of women prefer clinic-based testing over at-home self-sampling tests in the US.

Researchers from the University of Texas MD Anderson <a href="https://www.healthandme.com/health/cancer">Cancer</a> Center, Houston studied 2,300 women with an average age of 45.5 years. Most were married or living with a partner (58.2 percent), had health insurance (91.9 percent), and had at least some college education (61.6 percent).

Out of those analyzed, over 60 percent preferred clinic-based testing, 20 percent preferred at-home self-sampling tests and over 18 percent were unsure. However, women who had experienced prejudice or discrimination in healthcare were nearly twice as likely to prefer at-home testing.

The study noted that out of the women who preferred at-home testing, nearly 55 percent said it was due to greater privacy, over 35 percent said it was because of a lack of time and over 33 percent noted it was due to fear of embarrassment. 

Marginalized women, individuals with low income and individuals who do not trust the health care system were also more likely to prefer at-home self-sampling for cervical cancer screening or not know which option to choose.

To increase screening uptake, the researchers suggested that US officials should incorporate home-based self-sampling as an alternative to clinic-based testing, women’s education and empowerment should be enhanced and tailored interventions focusing on high-risk groups are needed to increase awareness and self-confidence in performing home-based self-sampling.

Cervical cancer develops in a women's cervix (uterus opening) due to abnormal cell growth, primarily caused by persistent HPV infection, a common infection that's passed through sexual contact.

When exposed to HPV, the body's immune system typically prevents the virus from causing damage however, in a small percentage of people, the virus can survive for years and pave the way for some cervical cells to become cancerous.

Treatment involves surgery, radiation, and chemotherapy, with early detection significantly improving outcomes, though it remains a major cancer in low-income countries Cervical cancer can also be prevented through vaccination and regular screening (Pap/HPV tests).

Cervical cancer has no symptoms in the early days and therefore, is hard to detect until it has spread. However, the early-stage symptoms include:

<ul><li>Vaginal bleeding after sex</li><li>Vaginal bleeding post-menopause</li><li>Vaginal bleeding between periods or unusually heavy/long periods</li><li>Watery vaginal discharge with a strong odour or containing blood</li><li>Pelvic pain or pain during intercourse</li><li>Advanced Cervical Cancer Symptoms (when cancer has spread beyond the cervix)</li><li>Painful or difficult bowel movements or rectal bleeding</li><li>Painful or difficult urination or blood in the urine</li><li>Persistent dull backache</li><li>Swelling of the legs</li><li>Pain in the pelvis or lower abdomen</li></ul><h2>Cervical Cancer: A Growing Crisis In India </h2>Despite being highly preventable as well as treatable, cervical cancer is a public health concern in India.

As per the World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus, about 42,000 new cases of cervical cancer is reported annually in India. This underscores the need for preventive measures such as vaccination and early screening. The country loses one women every eight minutes to cervical cancer.

The WHO Global Strategy to eliminate cervical cancer includes the 90-70-90 targets by 2030 -- vaccinating 90 per cent of girls against HPV, screening 70 percent of women, and ensuring treatment for 90 percent of those diagnosed with cervical disease.

In line with the global strategy to fight cervical cancer, Prime Minister Narendra Modi recently also launched a free HPV vaccination drive that will target health and well-being of adolescent girls in the country.

Union Health Minister JP Nadda has also announced that cervical cancer screenings using Visual Inspection with Acetic Acid (VIA) will now be available at Ayushman Arogya Mandirs and other health facilities for women between 30 and 65 years of age.

"Screening for cervical cancer is now available at 1,81,000 Ayushman Arogya Mandirs, also known as Health and Wellness Centers, across the country as a part of population based screening for early detection and treatment," said Nadda, while addressing a press briefing at the World Health Organization virtually.

Using VIA, a low-cost, point-of-care method, trained health workers will screen women for cervical cancer. Those who test positive will then be referred to higher centers for diagnostic confirmation and further evaluation.

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As cervical cancer screenings ramp up across the world, a new JAMA study shows that a majority of women prefer clinic-based testing over at-home self-sampling tests in the US. Researchers from the University of Texas MD Anderson Cancer Center, Houston studied 2,300 women with an average age of 45.5 years. Most were married or living with a partner (58.2 percent), had health insurance (91.9 percent), and had at least some college education (61.6 percent). Out of those analyzed, over 60 percent preferred clinic-based testing, 20 percent preferred at-home self-sampling tests and over 18 percent were unsure. However, women who had experienced prejudice or discrimination in healthcare were nearly twice as likely to prefer at-home testing.The study noted that out of the women who preferred at-home testing, nearly 55 percent said it was due to greater privacy, over 35 percent said it was because of a lack of time and over 33 percent noted it was due to fear of embarrassment. Marginalized women, individuals with low income and individuals who do not trust the health care system were also more likely to prefer at-home self-sampling for cervical cancer screening or not know which option to choose. To increase screening uptake, the researchers suggested that US officials should incorporate home-based self-sampling as an alternative to clinic-based testing, women’s education and empowerment should be enhanced and tailored interventions focusing on high-risk groups are needed to increase awareness and self-confidence in performing home-based self-sampling.What Is Cervical Cancer?Cervical cancer develops in a women's cervix (uterus opening) due to abnormal cell growth, primarily caused by persistent HPV infection, a common infection that's passed through sexual contact.When exposed to HPV, the body's immune system typically prevents the virus from causing damage however, in a small percentage of people, the virus can survive for years and pave the way for some cervical cells to become cancerous.Treatment involves surgery, radiation, and chemotherapy, with early detection significantly improving outcomes, though it remains a major cancer in low-income countries Cervical cancer can also be prevented through vaccination and regular screening (Pap/HPV tests).Symptoms Of Cervical CancerCervical cancer has no symptoms in the early days and therefore, is hard to detect until it has spread. However, the early-stage symptoms include:Vaginal bleeding after sexVaginal bleeding post-menopauseVaginal bleeding between periods or unusually heavy/long periodsWatery vaginal discharge with a strong odour or containing bloodPelvic pain or pain during intercourseAdvanced Cervical Cancer Symptoms (when cancer has spread beyond the cervix)Painful or difficult bowel movements or rectal bleedingPainful or difficult urination or blood in the urinePersistent dull backacheSwelling of the legsPain in the pelvis or lower abdomenCervical Cancer: A Growing Crisis In India Despite being highly preventable as well as treatable, cervical cancer is a public health concern in India.As per the World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus, about 42,000 new cases of cervical cancer is reported annually in India. This underscores the need for preventive measures such as vaccination and early screening. The country loses one women every eight minutes to cervical cancer.The WHO Global Strategy to eliminate cervical cancer includes the 90-70-90 targets by 2030 -- vaccinating 90 per cent of girls against HPV, screening 70 percent of women, and ensuring treatment for 90 percent of those diagnosed with cervical disease.In line with the global strategy to fight cervical cancer, Prime Minister Narendra Modi recently also launched a free HPV vaccination drive that will target health and well-being of adolescent girls in the country.Union Health Minister JP Nadda has also announced that cervical cancer screenings using Visual Inspection with Acetic Acid (VIA) will now be available at Ayushman Arogya Mandirs and other health facilities for women between 30 and 65 years of age."Screening for cervical cancer is now available at 1,81,000 Ayushman Arogya Mandirs, also known as Health and Wellness Centers, across the country as a part of population based screening for early detection and treatment," said Nadda, while addressing a press briefing at the World Health Organization virtually.Using VIA, a low-cost, point-of-care method, trained health workers will screen women for cervical cancer. Those who test positive will then be referred to higher centers for diagnostic confirmation and further evaluation.