HPV testing conversations

Innovation improves cervical cancer screening


Kaiser Permanente Northern California’s screening updates may help to reduce biopsies, other procedures among patients

Kaiser Permanente Northern California is advancing its cervical cancer screening program and will now be providing to members age 25-65 primary human papillomavirus or HPV testing to screen for cervical cancer, as opposed to the traditional Pap test. Primary HPV testing has proven more effective at detecting cancer and precancerous cells and is projected to significantly reduce the number of biopsies and colposcopies needed among women who test positive for HPV, the primary cause of cervical cancer.

“Our mission is to provide the best cancer screening for our patients and minimize harm, and that is exactly what this innovation achieves,” says Tracy Seo, MD, clinical lead, Breast and Cervix Cancer Screening and Outreach for Kaiser Permanente Northern California, and member of the Cervical Cancer Screening Guideline Development team for Kaiser Permanente Northern California.

This advancement in cervical cancer screening methodology is part of an initiative that analyzed data from 4.8 million test results of Kaiser Permanente Northern California members over nearly 20 years. The new testing guidelines, which suggest receiving primary HPV test every 5 years, aligns with the cervical cancer screening recommendations of the American Cancer Society. Kaiser Permanente is looking to transition to primary HPV screening nationwide in the upcoming years.

The HPV primary screening guidelines use an innovation known as “dual-stain testing,” which indicates whether a positive HPV is causing precancerous cervical cell changes more accurately than a Pap smear. The test measures the presence of high-risk HPV strains, allowing physicians to pinpoint more precisely who needs an additional procedure to further examine for cancer and precancer.

Our mission is to provide the best cancer screening for our patients and minimize harm, and that is exactly what this innovation achieves.

— Tracy Seo, MD

According to Dr. Seo, it’s projected that the need for biopsies, colposcopies, and other procedures among Kaiser Permanente Northern California members who test positive for HPV will be reduced by up to 60%.

“It does a much better job at detecting who will and will not benefit from having a procedure,” Dr. Seo says. “It’s an improved experience for the patient in reducing the possibility of an unnecessary procedure and gives time back to our physicians.”

Dr. Seo adds that Kaiser Permanente Northern California will be the first major health care organization to broadly use HPV dual-stain testing. This innovation was the result of a partnership between The Permanente Medical Group and the National Cancer Institute that started in 2003.

Decades of collaboration

What made this initiative possible was Kaiser Permanente’s integrated care system and the years of collaboration among multiple departments, particularly the Kaiser Permanente Northern California laboratory, according to the physicians involved.

“The hard work and dedication of our team was necessary to bring this innovative approach to cervical cancer screening to fruition,” says Julie Kingery, MD, interim medical director for the Kaiser Permanente Northern California Laboratory. “The collaboration with the women’s health leaders has allowed us to bring the highest level of care to our members.”

Kari Carlson, MD, director of Women’s Health for Kaiser Permanente Northern California, says she believes this work will influence cervical cancer screening guidelines nationally and will provide better preventive cervical cancer care to all women.

“The coordination and integration among so many teams involved in this work is something I am incredibly proud of,” Dr. Carlson says. “It took the dedication of our lab, health engagement teams, technology partners, quality assurance teams, and many more to make this more accurate, efficient test accessible to women.”

Learn more about cervical cancer screenings.

This is reprinted from the Look Inside Kaiser Permanente Northern California site.