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Cervical Cancer Screening With Human Papillomavirus Self-Collection Testing in an Opioid Treatment Program
Elizabeth M Swisher1, Mallory Davis2,3, Mayumi Rubin-Saika1
1Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, University of Washington, Seattle.
JAMA Network Open
|July 29, 2026
Summary
Human papillomavirus (HPV) self-collection testing is feasible for cervical cancer screening in patients with opioid use disorder (OUD) and substance use disorder (SUD). High uptake and eligibility were observed, demonstrating a viable approach to increase screening access for underserved populations.
Area of Science:
- Oncology
- Infectious Diseases
- Public Health
Background:
- Individuals with opioid use disorder (OUD) and substance use disorder (SUD) exhibit lower cervical cancer screening rates compared to the general population.
- Human papillomavirus (HPV) self-collection testing offers a promising strategy to enhance screening accessibility for previously underserved patient groups.
Purpose of the Study:
- To evaluate the feasibility and uptake of integrating HPV self-collection testing for cervical cancer screening within the routine care of patients with OUD and SUD.
- To monitor high-risk HPV detection rates and the adherence to guideline-concordant follow-up care in this specific patient cohort.
Main Methods:
- A prospective cohort study was conducted at an opioid treatment program (OTP) and American Indian Health Facility.
- Eligible patients (≥25 years, with a cervix, overdue or unsure of last screening) were offered HPV self-collection kits during annual wellness visits.
- Samples were analyzed for 14 high-risk HPV types, with HPV-positive patients receiving education and facilitated referrals for guideline-concordant care.
Main Results:
- Of 174 eligible patients, 158 (90.8%) completed HPV self-collection testing, with high eligibility and uptake.
- HPV positivity was detected in 30 patients (19.0%), including HPV-16/18 in 7 (4.4%) and other high-risk types in 23 (14.6%).
- Among HPV-positive patients, 40.0% completed follow-up care to date, with 53.3% actively engaged in referral and scheduling processes.
Conclusions:
- Integrating cervical cancer screening via HPV self-collection testing into an OTP setting is feasible.
- The high patient eligibility and testing uptake demonstrate the potential of this approach to improve screening rates in populations with OUD and SUD.
- While linkage to follow-up care requires significant coordination, the feasibility of screening is established, highlighting an opportunity to address disparities in cervical cancer prevention.
