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Científica en un laboratorio moderno sosteniendo un kit de autotoma para detección del VPH
Imagen alusiva a un laboratorio y un kit de autotoma para la detección temprana del VPH. · Imagen generada por EPM

Colombian home test aims to flag cervical cancer risk earlier

A self-sampling device promoted by Colombian scientists lets women collect at home a sample to detect human papillomavirus and, with a molecular biomarker…

--- The context --- Each year, nearly 14 out of every 100,000 Colombian women are diagnosed with cervical cancer and mortality exceeds 50 percent. In Latin America, about 180 receive that diagnosis daily and more than 90 die. Behind those figures lies a challenge that goes beyond technology, ensuring that women gain timely access to detection tests and receive prompt care when the result requires it, instead of arriving after the disease has advanced. The conventional examination requires inserting a speculum to access the cervix, an experience some consider uncomfortable, painful or embarrassing. According to Frank Meléndez Montoya, barely 45 percent of women in the country take part in screening campaigns when that method is used. That low participation, together with the distance from services in many regions, helps explain why so many diagnoses still arrive late despite the availability of molecular testing. --- The facts --- MIA by CytoTest is a self-sampling device that allows a vaginal sample to be collected at home and later analyzed in a laboratory. It has a slim design, similar in use to a sanitary tampon, and collects cells through adhesion. The woman inserts it partially into the vaginal canal, rotates it three times, removes it and places the sample in a dry container to send to the laboratory, without necessarily having to reach the cervix. The sample is used exclusively for molecular testing. First, DNA is analyzed to determine whether human papillomavirus is present and, when the result is positive, a biomarker based on messenger RNA E6 and E7 is applied, linked to the activity of viral proteins involved in the cancer process. These are three complementary components, self-sampling, virus detection and molecular stratification, while clinical interpretation remains in the hands of the health professional. The virus includes nearly 200 identified genotypes, most of them low risk, while 14 are considered high risk because of their relationship with cancer. Seven of them, 16, 18, 31, 33, 45, 52 and 58, account for 92 percent of cervical cancers globally, according to the researchers, and they are the same genotypes covered by the vaccine. Having the virus does not amount to having cancer, because the immune system spontaneously clears between 80 and 90 percent of infections. The sensitivity comparison completes the technical picture. Conventional cytology has sensitivity close to 50 percent, while molecular DNA tests raised that capacity to 96.5 percent, according to the figures provided by the team. Even so, detecting the virus does not always make it possible to establish which patients require priority care, so the biomarker is proposed as a complement that adds information about risk in women who obtain a positive result. --- The positions --- Liliana Montes Correa, an engineer from Cali and global chief operating executive at Mel Mont Medical, and Frank Meléndez Montoya, from Medellín and global executive for clinical and commercial affairs at the company, take part in a development that began in Oslo, Norway, in 2003. Although they have lived outside the country for decades, they promoted manufacturing the device in Colombia. Montes said the starting point was differentiating who is at risk, who should receive priority management and who can wait, while Meléndez argued that the central challenge was getting women to participate. The evidence presented covers two distinct lines. Since 2003, studies of the biomarker have included 127,000 women from Europe, Africa and Mexico, with findings published in 28 scientific articles. Separately, validation of self-sampling in Mexico, Spain and the United States, with participants aged 25 to 64, compared a sample taken by a professional with a speculum against one collected by the women themselves guided by a leaflet, and showed 95.5 percent agreement, according to Montes. Those studies included 1,050 and 450 women in Mexico, 275 in Spain and 360 in the United States, figures reported by the researchers for the device. --- What remains unknown --- In Colombia, MIA still depends on health authorization. Montes said the process before the National Institute for Food and Drug Surveillance is advanced and estimated that approval could arrive in three or four months. In the United States, according to Meléndez, the DNA test and the biomarker already have approval, while the device for collection at home remains under evaluation, with a notification expected in 60 days and implementation projected from January 2027. --- Unanswered questions --- When will the process before the Colombian health authority conclude and under what conditions could self-sampling be offered in the country? How will it be guaranteed that a woman in a remote area with a positive result receives later care without delays that cancel out the advantage of detecting it earlier? Who will assume processing of the samples, communication of the results and the costs of the complete process in each territory? --- EPM analysis --- The proposal gains a social dimension in remote regions. Meléndez mentioned Vaupés, the Amazon, the Orinoquía and the Pacific coast, where health infrastructure is limited and transporting samples can delay results. The purpose described is to support rural brigades with devices and trained personnel, process samples in reference laboratories and make it easier for teams to return to communities. The idea, he said, is that a woman can take the sample in complete privacy and obtain molecular results within seven days instead of months. From an equity perspective, the potential value lies in bringing the first step closer to those who participate least today. If sampling can be done at home and in privacy, a barrier that the conventional method did not overcome could be reduced. But self-sampling does not remove the need for a system that processes samples, communicates results and guarantees later care, and that complete chain is what still must prove it can work in a sustained way in daily practice. 📌 EPM Take: In EPM's view, the relevance of this proposal lies in joining three pieces that separately were not enough, a sampling method women will actually accept, more sensitive molecular detection and a way to distinguish real risk among so many positive results. Its greatest promise is territorial, reaching places where the speculum, distance and embarrassment left many outside screening. But that promise only becomes public health if authorization arrives, if laboratories respond on time and if every positive result finds effective care and guaranteed follow-up for each woman tested.
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