Less than two-thirds of women are up-to-date on their screenings for the deadly cancer. Nurx has a new at-home test to help fix that. Here's what ob-gyns say.

By Rachael Schultz
January 22, 2019
Photo: Nurx

Getting your eyes checked, changing your oil-there are a whole lot of things we're supposed to do as adults that get put on the back burner so we can do all the things we have to do. And, apparently, getting a Pap smear falls on the former list: According to a study from the Mayo Clinic out earlier this month, not even two-thirds of women are up-to-date on their cervical cancer screenings.

To put this scary statistic into perspective, the American Cancer Society estimates that more than 13,000 new cases of invasive cervical cancer will be diagnosed in 2019, and more than 4,000 women will die from cervical cancer. (Related: Cervical Cancer Is Deadlier Than Previously Thought)

Consumer health company Nurx (which also offers birth control delivery) wants to help. Last week, they launched a home HPV screening test to help women check their risk of cervical cancer without having to leave the house or pay for a doctor's visit.

Here, everything you need to know about how it works-plus what ob-gyns think about the DIY-swabbing method.

How At-Home HPV Testing Works

The idea: You fill out a few questions on the Nurx app and your answers are reviewed by a doctor. As long as you don't have a personal history of cervical cancer and haven't had an abnormal Pap result in the past, you're cleared. Nurx sends you a kit with detailed instructions, you send back a swab, and your sample is tested for high-risk strains of HPV to help catch cervical cancer early. (Related: How a Cervical Cancer Scare Made Me Take My Sexual Health More Seriously Than Ever)

Nurx tests for 14 of the highest-risk strains of HPV-including the two that cause nearly 70 percent of cervical cancer diagnoses. And it uses the only FDA-approved HPV test, the same one your doc uses. (Quick distinction: The FDA does not sign off on this at-home method of collecting the swab sample-as opposed to retrieving this same swab at a doctor's office-but studies do show it's a pretty reliable and accurate method for women who can't make it to a doctor.)

And this concept isn't entirely new. Dozens of companies are launching at-home health screening kits, including an STD kit from uBiome that covers the same 14 HPV strains. But because the competitors also check for other major STDs, Nurx is running fewer labs and therefore is far cheaper ($69 without insurance, $15 with a co-pay), not to mention focused specifically on catching precancerous cells early. (Related: How Often Should You *Really* Get Tested for STDs?)

So, Is At-Home HPV Testing Legit?

The most important risk factor for developing cervical cancer is the presence of the high-risk types of HPV, says Natasha Chinn, M.D., an ob-gyn at Brescia & Migliaccio Women's Health in Hoboken, NJ. And it is indeed important to catch it early to treat the cells in a precancerous state. However, "an HPV test alone is not an adequate screening test for cervical cancer," adds Dr. Chinn.

Let's back up for a minute. Traditionally, there have been two ways women over 30 were advised to be screened for cervical cancer: a Pap smear every three years, or both a Pap and an HPV test every five. In August 2018, though, the U.S. Preventive Services Task Force updated their guidelines to say women in this age group can also just get an HPV test every five years, a stance supported by the American College of Obstetricians and Gynecologists.

From this perspective, Nurx-which uses both real docs via the app and the FDA-approved HPV test-is a great avenue to help women who can't get in to their ob-gyn's office to check their cervical cancer risk. Using a mail-order kit would give initial test results to women who might not otherwise have access to testing. The results may alert them that they need a closer follow-up in person, says Jessica Horwitz, director of clinical development for Nurx and a board-certified family nurse practitioner.

However, both Dr. Chinn and Laura Alsina-Sanchez, M.D., an ob-gyn at Partners in Women's Health in Jupiter, FL, agree women are best off still getting a Pap, either with an HPV test every five years or alone every three. The new guidelines are based on constantly evolving research and trends, but "as gynecologists, we practice evidence-based medicine and, so far the evidence shows us that a Pap smear is necessary for adequate screening," Dr. Chinn explains. (Related: How Often Do You Really Need to Get a Pap Test?)

Dr. Alsina-Sanchez agrees: "You can have a negative HPV test but still have precancerous cells that only a Pap would find, which is why they're best used together."

Dr. Chinn adds that taking an HPV test alone, then waiting three to five years per the guidelines to get a Pap, puts women at risk of having precancerous cells or cancerous cells. This could give women a false sense of security, delay potential treatment, and increase the risk of needing more extensive treatment if the cells advance.

FWIW, women under 30 shouldn't use Nurx-or get any HPV test, for that matter-unless their doctor orders it in response to an abnormal Pap. Why? "HPV is very common [before 30] and once acquired, most strains are cleared from the body in two years," explains Dr. Alsina-Sanchez. "Testing for HPV in this population can lead to additional procedures, anxiety, and stress without significant reduction in cervical cancer."

What's more, both docs point out that while using a swab isn't rocket science (and, as we said, the science deems it highly reliable), it does leave room for operator error and, therefore, inaccurate results.

The Bottom Line

Every woman over 30 should be prioritizing a Pap smear at her doctor's office as the way to decrease her cervical cancer risk, both ob-gyns agree. If from there you need an HPV test, your doc will take care of it. That said, not enough women actually making their way to their doctor's office and we need alternative ways to ensure they are getting tested, the Mayo Clinic study concluded. And that's exactly what Nurx does-with legit science and technology. Bottom line: If you can't get in to see your doc for whatever reason, using their high-quality at-home test is certainly better than waiting.