Doctors unveil self-testing kits to screen for cervical cancer

The HPV DNA Self-Sampling Kit adds a new option that may encourage more women to undergo screening. The new self-testing kit is designed to be administered once every five years.

Roche Diagnostics (Thailand) Co., Ltd joins hands with National Cancer Institute Thailand, National Health Security Office and Chonburi Cancer Hospital to organize an online academic seminar "Women Must Know: HPV DNA Self-Sampling Test, an Alternative way for Cervical Cancer Screening without getting pelvic examination on a gynaecological table".

The seminar aims to educate and provide information on the importance of HPV DNA screening for cervical cancer for the public, especially the target group of women who can now collect samples by themselves in the hospital.

It also hopes to provide more alternative ways of screening and reduces concerns in various fields such as fear of pain, the embarrassment of doctors, as well as worries about expenses which are confirmed the screening test and treatment are covered by the health scheme.

It's believed that early detection of HPV can help reduce cervical cancer risk and mortality. The seminar was held via Roche Diagnostics Thailand's YouTube live: https://www.youtube.com/watch?v=jU0tvmPRpgE  

Dr Piyawat Laowahutanont, Director of Chonburi Cancer Hospital and a doctor specialising in Gynecologic Oncology revealed that although cervical cancer is the most common cancer in women from young to old and it is the 5th most common cancer found in Thai women after breast cancer, colon cancer, liver cancer, and lung cancer, it's one of the few cancers that is preventable if it has been screened correctly and regularly.

Cervical cancer is caused by infection with the HPV virus with a period of 10 years of disease progression from infection to cell changes until it develops into cancer.

Currently, there are 5,422 cervical cancer cases in Thailand, according to a forecast in 2017, with a slight decline of 5,320 cases steadily in 2020.

Currently, the incidence of cervical cancer is 11.1 per 100,000 people, but the World Health Organization wants all countries to reduce the incidence of cervical cancer to 4 per 100,000 people.

Therefore, Thailand still has to carry out intensive cancer screening together with vaccination for schoolchildren. There are many factors that make women neglect to attend cervical cancer screening, such as not knowing cervical cancer is caused by high-risk HPV strains (genotypes 16 and genotypes 18).

If the infection is detected early, it can be diagnosed and treated early before the infection causes abnormal cells and develop into cervical cancer. It was also caused by personal reasons such as fear of going to a gynecologic table, fear of injury, embarrassment from doctors and concerns about the cost of the examination and treatment if they're found to have cancer and etc.

Thus, many women visit the doctor when they already have symptoms and are found to have cervical cancer which is too late. Unfortunately, if patients regularly undergo HPV screening, it can reduce the risk of cancer as well as ultimately reduce the mortality rate from this disease.

When there are more options for testing for people at risk, with the opportunity to choose to collect samples by themself to detect HPV which is the main cause of cervical cancer.

" This is different from the Pap smear test that detects cell abnormalities which must wait for abnormal cells to be detected. With the HPV DNA Test, it is believed that it should increase the comfort of the patients in the examination and will be able to plan treatment in a timely manner" Dr Piyawat said.

Dr Suleeporn Saengkrachang, Deputy Director of Health System Development of The National Cancer Institute addressed that Thailand has a policy and planning for service and treatment as well as the health system support for cancer treatment from the government which is recognized as one of the tops of the world.

Bringing the innovation of the HPV DNA Test for cervical cancer screening is one of our intentions to create awareness as well as to create correct understanding to realize the importance of getting screened, including the right to access appropriate treatment which is the long-term strategy of the institute with guidelines for diagnosis in the laboratory that focuses on implementing HPV DNA test nationwide.

Diagnosis of infection must still be carried out by a medical technician in the laboratory or lab only, according to the practice guidelines. However, there will be more options for women to choose whether they want doctors to collect samples as usual or choose to collect samples themselves which must be done in a hospital only.

The nurse will advise you on how to collect samples according to the instruction manual carefully and accurately. Patients must do vaginal self-sampling swabs with a swab stick as instructed in the bathroom and place the swab stick in the specimen box and send it to the laboratory for further analysis.

Hence, when receiving the results of the screening test from the doctor, if HPV is found, patients can develop an appropriate treatment plan with their doctor early on.

On the other hand, if HPV is not found, patients can plan a screening visit again in the next 5 years—no need to recheck every year which is considered another advantage that is different from the traditional cervical cancer screening test" Dr. Suleeporn said and underlined that the HPV DNA self-sampling test for cervical cancer screening is not available in general pharmacies at the moment.

It's a new option available in government and private hospitals where patients can choose to undergo according to their own needs and medical rights.

Dr  Attaporn Limpanyalert, Deputy secretary-general of the National Health Security Office (NHSO) stated that NHSO has goals, policies and strategies of the NHSO in eliminating cervical cancer completely at present and in the future, including providing cervical cancer screening benefits coverage and groups of people, starting from getting screened and providing treatment.

At present, the NHSO has integrated a campaign to actively provide Thai women aged 30-60 years old free cervical cancer screening, using an HPV DNA test, covering all rights nationwide. The collaborative campaign is organized by the provincial public health office and its network of services in each area.

The screening test has been changed from the Pap smear technique which was used in the past, but this year, the new testing method has been adjusted to the HPV DNA test technique or the DNA test to detect HPV which is more accurate and sensitive.

And now we have the newest option, the self-sampling HPV DNA test which women can collect sampling themselves and get the results within 1 month. In the past, there were more than 822,301 cervical cancer screenings among women aged 30-60 years.

Cervical cancer has a chance to be cured if it is taken care of at an early stage. Therefore, to increase the effectiveness of screening and to comply with guidelines (Guideline) revised in September 2018 of the Royal College of Obstetricians of Thailand, the Board of NHSO decided to add "Incentives for cervical cancer screening by HPV DNA Test" to replace the Pap smear method every 5 years by NHSO. And the NHSO supports the budget in the form of payment according to the service list (Fee schedule).

Cervical cancer screening by HPV DNA test technique costs the same amount as the conventional technique, but the difficulty is how to get the target group, in a large number come and get screened.

So, we hope that the new added HPV DNA Self-sampling would be one of the solutions that help ease up the difficulty, including the establishment of a public inspection unit in community areas and health insurance rights which are also expectedly to be another mechanism to increase people's access to screening tests. 

Pichetpong Srisuwankul, Managing Director of Roche Diagnostics (Thailand) Co., Ltd said that the public health industry whether public health care and private sectors around the world are sharing big challenges in completely eliminating cervical cancer, trying to reduce women's anxiety and increasing access to cervical cancer screening. For these reasons, innovations in cervical cancer screening have been developed using the HPV DNA method and alternative to self-sampling to detect HPV which is the main cause of cervical cancer.

Roche Diagnostics Thailand, as a developer of laboratory diagnostic tools and supporters of today's seminar, thinks that the development of knowledge to encourage people as well as medical personnel who are well versed in the healthcare industry is very important along with the development of innovative analytical tools to provide diagnosis, treatment and prevention so that people can take care of their health properly and effectively.

" I hope that the cervical cancer screening by HPV DNA Self-sampling technique without undergoing on the gynecologic table would be another option for ladies to more screening tests for themselves and their loved ones," Pichetpong said.