January is National Cervical Cancer Awareness Month, which focuses on a simple message: Prevention and early detection can save lives. Now a major innovation aims to advance this effort — at-home testing for human papilloma virus (HPV), the cause of nearly all cervical cancers.
On Jan. 5, the Health Resources and Services Administration announced its updated cervical cancer screening guidelines, which spotlight the self-collected HPV test — known as the Teal Wand —as a new option for women at average malignancy risk (ages 30 to 65). This recommendation is supported by most major medical organizations, including the American Cancer Society and American College of Obstetricians and Gynecologists.
The guidelines identify HPV testing every five years as the preferred screening method (either self- or provider-collected). Accepted alternatives include an HPV/Pap smear co-test every five years, or a Pap smear alone every three years. (Women over 65 with three consecutively normal Pap smears need no further testing.)
HPV is a common sexually transmitted infection, and it is virtually symptom-free. There are two main types: low-risk, which can cause warts, and high-risk, which can cause cervical cancer (and less frequently, throat, anal, or tongue cancer in both men and women). The immune system clears the virus within two years in 90% of cases; but one in 10 women with high-risk HPV develop a persistent cervical infection, which can lead to precancerous cells or malignancy.
Regular gynecologic checkups including HPV and Pap tests have helped make cervical cancer one of the most preventable malignancies. But one in four women skip regular screening, and the rate doubles to one in two for those living rurally — largely due to the difficulty in accessing preventive care. As a result, nearly 13,500 American women are diagnosed with cervical cancer annually, most between the ages of 35 and 44. More than 4,200 victims die from the disease every year.
Recent research has shown that HPV testing is more sensitive and reliable than Pap smears in finding precancerous cells. And unlike a Pap smear, which requires a clinician-performed pelvic exam and cervical sampling, home-based HPV screening can be done by a quick vaginal self-swab — making the test more private, comfortable, and accessible.
Named for the colorful ribbon symbolizing cervical cancer awareness, the Teal Wand is currently the only self-administered test approved by the Food and Drug Administration. Access requires a prescription from a Teal medical provider following a telehealth visit to determine eligibility. (Individuals at high risk for cervical cancer, such as those with a history of precancerous cells or a suppressed immune system, are not candidates for at-home testing and should be monitored by health professionals.)
Approved patients receive the Teal Wand by mail, then send the completed sample to a Teal-designated certified laboratory. Negative results (no HPV detected) are uploaded to the patient’s secure online portal. Positive results are reviewed via telehealth with a Teal clinician, who coordinates follow-up care with a local gynecologist.
The Teal Wand is covered by Medicaid, Medicare, and most private insurances. Without insurance, the average cost is $249.
The best way to prevent cervical cancer is by vaccination against HPV, which is nearly 100% effective; the two-dose immunization series is given between the ages of 9 and 12, with catch-up vaccination given until the age of 26.
Dr. Mary Jenkins, a contributor to the Herald and member of its board of directors, retired after nearly 40 years as a family practice physician in New York state.