Self-testing kit for sexually transmitted infections may be coming this fall

This fall, Canadian women may be able to self-administer tests for sexually transmitted infections from the comfort of their own homes, for less than $100. 

Produced by Toronto company Eve Medical, the kit will be available for order online. It will arrive in a unmarked envelope for privacy, and include a self-testing kit and a pre-addressed envelope destined for a Toronto-area lab that is partnering in the initiative.

The self-testing kit is designed to test for gonorrhea, chlamydia and human papillomavirus (HPV), the latter of which is a risk factor for cervical cancer. Eve Medical promises its results via mobile app within a few days. 

Currently, Ontario women have to attend a clinic and pay for HPV tests, which cost around $90 according to Cancer Care Ontario. 

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Co-founder and OCAD graduate Jessica Ching has been fine-tuning the self-testing device for about six years. Two steps remain before the kit can go to market: the company needs to finalize its patient portal, and it needs to conduct one more test with the partner lab to demonstrate the accuracy of its results.

"I'm so proud of our team for putting together a device I really believe could help a lot of people," says Ching. 

At the heart of her initiative, she says, is the hope of making it more convenient for women to test for HPV which she hopes could guard against cervical cancer.

But gynecologic oncologist Dr. Joan Murphy says self-testing for HPV poses several problems, including the possibility that it will lead to some women seeking out unnecessary treatment. 

Self-testing potentially risky

Murphy, the clinical lead for Cancer Care Ontario's cervical screening program, has been working to improve cervical cancer screening in the province, which would include funding for HPV testing. Currently, the province pays for vaccinations for youth, but not testing. 

She says 30 to 35 per cent of Ontario women who should be screening for cervical cancer are not doing so. And she says self-testing devices like Eve Medical's could help to reduce this statistic.

But she's also concerned self-testing devices could also lead to unnecessary medical procedures. 

"Women aged 21-30 are very likely to have an HPV infection, and it's very likely to mean almost nothing," she says, noting that many strains of HPV don't lead to cervical cancer.

A woman who tests positive for HPV can request a Pap smear from her doctor to see if she has abnormal cells in her cervix. If she does, the question is whether the abnormal cells should be removed as a preventative measure, out of concern they will lead to cervical cancer. However, Murphy says for many women, the cells will return to normal without medical intervention.

Additional treatment can be risky

Murphy says there is a grey zone when it comes to who qualifies for this preventive cervical cancer procedure, and self-testing could mean more women enter this zone. This is concerning, Murphy believes, because the procedure comes with its own risks.

"The treatments we offer to people we believe to have pre-cancerous changes in the cervix can lead to bleeding, pain, infection," she says.

There's also a small risk, Murphy says, that the treatment could cause problems during a future pregnancy. 

HPV is different than other STIs, Murphy says. While HPV tests are only required once every three years, Murphy recommends sexually active women should be tested for other STIs much more frequently.

To reduce the risk of unnecessary over-testing and associated affects, Ching says she will link to Cancer Care Ontario guidelines regarding who should seek HPV testing on her website.