Do you regularly skip cervical cancer screening? Maybe you’re too scared to go the doctor, or live in an area where it’s not particularly easy to access health services. Or maybe you don’t think it’s that big of a deal… after all, doesn’t HPV usually clear up on its own?
According to a 2015 Canadian Partnership Against Cancer report, around one in three Canadian women regularly skip cervical cancer screening—for many reasons, including the ones listed above—but there’s a new option aiming to change the way we think about testing and improve access in one go.
Eve Kit is Canada’s first at-home HPV test. Created by Toronto-based Eve Medical, the system lets you test for high-risk strains of human papillomavirus (HPV), a potentially cancer-causing sexually transmitted infection—without having to make a trip to the doctor’s office. Since its launch in mid-March, more than 200 Eve Kits have been sold, each at $110 a pop. A 2.0 version is currently in the works (and slated to hit shelves by the end of this year), which would expand testing to include chlamydia and gonorrhea.
Marketed as “very friendly and very inviting,” Eve Kit seems like an easy solution for women who might otherwise skip screening. But is at-home testing a good idea? FLARE decided to take a closer look at the product and talk about it with a gynecologist and doctor who specializes in infectious diseases. Here’s what we learned.
How it works
Eve Kit is the brainchild of industrial designer and healthcare entrepreneur Jessica Ching, the co-founder and CEO of Eve Medical. It started out as her thesis project at OCAD University. Together with her research partner, Nancy Seto, she set out to find an easy and discreet way to test for sexually transmitted infections at home.
Each Eve Kit contains a Health Canada-licensed HerSwab, which Ching describes as “a tampon with a handle on it.” It allows you to swab near your cervix, where HPV strains may be found. Then you put the swab in the provided packaging and mail it to a downtown Toronto lab, where it’s processed using the same tests your doctor would use.
In seven to 10 days, test results are confirmed. An email notification is sent with directions to Eve Kit’s secure online portal—that’s where you’ll see if you tested negative or positive and can also access educational material on HPV.
As Ching explains: “Every person who orders a kit is assigned a physician. If there’s a positive result, the assigned doctor would call them and counsel them through any next steps.”
To make sure that Eve Kit is a good fit, potential users first answer several questions about their sexual activity and whether they’re pregnant. Depending on your answers, Eve Kit may recommend that you skip the kit and go directly to a doctor.
Why it’s important to get tested
HPV is the most common STI out there—and gynecologists like Dr. Deborah Money agree that it usually clears up on its own with no consequences. But in some cases, it can develop into cervical cancer, which is why regular testing is important even for women have been vaccinated. “The HPV vaccine does not protect against all types of cancer-causing HPV and we still do not know for how long it will be effective,” says Money, a professor of obstetrics and gynecology at the University of British Columbia, who is not affiliated with Eve Kit.
For most healthy women, that testing comes in the form of a Pap smear, which the Society of Obstetricians and Gynaecologists of Canada recommends getting every three years. There’s a difference between the Pap and an HPV test, explains Money. “The Pap smear tests for abnormal cells that have the potential to become cancerous on the cervix, while an HPV test determines whether there is a cancer-causing HPV virus present,” she says.
While both tests can be done together, usually a Pap smear is performed first and then, if certain types of abnormal cells are detected, a HPV test may be conducted to see if you’ve been infected by the virus, which can sometimes trigger those abnormal cells.
Ching’s at-home option bypasses the Pap. “In this case, what we’re doing is flipping it and saying well, if you’re not going to go and do a Pap test, at least do a HPV test to know if you do have the virus,” says Ching. “If you do have the virus, then a Pap test is what you’d be doing next.””
What a doctor thinks
When it comes to at-home STI testing, there are obviously advantages and disadvantages, says Dr. Barbara Romanowski, a clinical professor in the division of infectious diseases at the University of Alberta, whose research interests include sexually transmitted diseases, HPV, HIV and other genital infections.
She’s familiar with Eve Kit and sees a place for it, acknowledging that for some women, accessing a doctor simply isn’t possible. While Romanowski would consider recommending the kit in this situation, she does offer an alternative for women who can access a clinic but don’t want to do a pelvic exam: a urine test, which can detect chlamydia and gonorrhea, but not HPV, she says. And unlike Eve Kit, this testing is covered by your government health insurance.
For Romanowski, the biggest downside to at-home STI testing is that it might result in women skipping a pelvic exam. While she acknowledges that these exams “are awful,” she explains that, “a pelvic exam is so much more than just testing for STIs,” as it also involves examining the vagina, cervix and ovaries for potentially dangerous abnormalities.
“Better some screening than no screening,” says Romanowski of at-home options like Eve Kit, but she wants to make sure people truly understand what the end result of using Eve Kit might be. “If your test comes back positive–what are you going to do?” she asks, “Using an at-home kit doesn’t mean you’ll never have to have one of those awful examinations in a doctor’s office.”
Bottom line: Eve Kit can be a valuable tool
Eve Kit isn’t for everyone, cautions Romanowski, who says that women with past histories of vaginal or cervical abnormalities as well as those who have genital warts should skip it—something Ching also acknowledges.
Neither Romanowski nor Ching believe that Eve Kit will ever replace the doctor’s office. Ching openly encourages women who are comfortable with their doctors to keep seeing them for screening. But she knows that not everyone has that choice.
One group that might especially benefit from Eve Kit are survivors of sexual trauma, who understandably may be reluctant to see a physician. “Eve Kit, or the availability of self-administered anything—as long as the quality of care and medical oversight isn’t impacted—can be helpful here because the person is in control of the sampling process,” says Ching. “They can use the sampling device at their own pace and in their own environment.”
As well, says Ching, the tool should ultimately result in more people getting the healthcare they need: “My hope is that by engaging people in their own care, and putting them in control of the first step, they will be more willing to take the next step and further engage with a healthcare provider if required.”