HMN 2025: How Direct-mail HPV self-test kits boost screening rates and are cost-effective

New research published in JAMA Network Open finds that mailing human papillomavirus (HPV) self-sampling kits to patients is a cost-effective strategy for increasing cervical cancer screening completion rates. Long-term infection with high-risk HPV strains can cause abnormal cell growth, which could progress to cervical cancer. The study is the first to examine the cost-effectiveness of these mailing strategies across different patient screening histories within a U.S.-based health system.

“Mailed HPV self-sampling kits have been shown to increase screening rates, but there are limited data on the cost-effectiveness of this approach in the U.S.,” said Dr. Rachel L. Winer, the study’s lead author and an affiliate investigator at Kaiser Permanente Washington Health Research Institute. “Our findings provide a strong economic justification for health systems to implement mailed HPV self-sampling within their cervical cancer programs, especially since they can reach a wide range of patients.”

Researchers looked at more than 31,000 female Kaiser Permanente Washington members aged 30–64 between November 2020 and July 2022. The evaluation assessed different patient groups based on their screening history: screening-adherent, overdue, and unknown history.

The study found that for screening-adherent members, directly mailing HPV kits was more effective and cost-saving than usual care. For members overdue for screening, directly mailing kits was also more effective than usual care and either cost-saving or associated with a minimal additional cost, depending on the scenario.

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