Self-screening for cervical cancer

While in a mall, Kristin (not her real name), a 36-year-old teacher in Novaliches, paused before a drugstore poster offering a free test for cervical cancer. Her deceased friend’s late-stage diagnosis reignited her fear of having the same disease. But hope triumphed. A drugstore worker explained that Kristin could collect the test sample herself, privately, no speculum needed. Within minutes, she took control of her health.

Cervical cancer need not be a devastating burden for women. Now that the human papilloma virus (HPV) DNA test can innovatively be used as the first screening tool and boosted by its accuracy and the ease of self-sampling, women at risk of the cancer can now be easily identified. This dismantles barriers of fear, inconvenience, and stigma, and places early cancer detection literally in women’s hands.

Every year, cervical cancer claims over 4,000 Filipino lives, and nearly 7,900 new cases are diagnosed. It is the second most common cancer among 30- to 49-year-olds—women in their prime caregiving and income-earning years. Despite free screening programs, however, fewer than 20 percent of eligible Filipino women are screened. Many avoid the procedure due to time constraints, the discomfort of pelvic examination, and shame from the stigma of HPV being sexually transmittable.

HPV self-sampling

Self-collection of HPV DNA sample makes screening private, painless, and convenient. Studies show self-sampling is as accurate as clinician-collected sampling for detecting high-risk HPV types that lead to cervical cancer.

In the Philippines’ Scale Up Cervical Cancer Elimination with Secondary prevention Strategy (SUCCESS) project, 96 percent of participants across urban and rural communities successfully self-collected samples, and 94 percent of them found the method acceptable. The samples, moreover, do not have to be collected in clinics. Self-sampling can be done in pharmacies, workplaces, or homes—a flexibility critical for reaching underserved groups.

The SUCCESS project

Jhpiego, a global NGO for public health and an affiliate of the Johns Hopkins University, works closely with the Department of Health (DOH) through SUCCESS to strengthen the national program for cervical cancer elimination. The project is funded by Unitaid, in tandem with the private sector-funded Centralized Laboratory Model for HPV DNA Screening (CLAMS) Project. These SUCCESS initiatives are being implemented in the Philippines and three other countries.

SUCCESS and CLAMS aim to shift cervical cancer detection from opportunistic to organized and population-based cervical cancer screening, leveraging innovative tools like self-collection, HPV-DNA testing, thermal ablation, and digital health solutions. They integrate HPV testing into current services for family planning, reproductive health, primary health, and HIV management in more than 350 public health facilities nationwide. They reach 31,000 women aged 30 to 49.

Key outcomes include high participation among unscreened women, screening becomes a normal part of routine care as HPV testing is integrated in ongoing health services, precancer care becomes more accessible through treatment with thermal ablation even in clinics and small hospitals and reduces the number of women who do not return for follow-up. These indicate that when screening is accessible, private, and convenient, participation soars.

Modernization and scaling up

To eliminate cervical cancer, the Philippines must prioritize the HPV test as the primary screening tool nationwide and encourage self-sample collection. The requirements are:

Institutionalizing HPV testing as a DOH policy and allocating funds for community-based HPV testing programs.
Increasing access to screening and precancer treatment through public-private partnerships that will expand screening services through pharmacies, corporations, and civil society organizations like Women’s Health Empowerment Network, and collaboration among organizations of obstetricians, gynecologists, and nurses.
Enhancing public health education to combat stigma and misinformation with campaigns that emphasize “Cervical cancer: Kayang iwasan, kayang agapan!”

Cervical cancer is preventable but only if we act. Your health is in your hands. Self-collect—not just for ourselves, but also for our families and communities. A minute of courage can save a lifetime. Seize this opportunity to end cervical cancer, one swab at a time.

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Cecilia Ladines-Llave, MD, PhD, a gynecologic oncologist, is technical advisor for cervical cancer screening and treatment for DOH-Jhpiego’s SUCCESS project. Enriquito Lu, MD, MPH, obstetrician-gynecologist and reproductive health advocate, is SUCCESS advisor for the Johns Hopkins University affiliate Jhpiego. 