Cervical cancer screening is about to change as cases rise among young women. Here's what you should know.
- New testing options could make it easier to screen for the most common cause of cervical cancer.
- An FDA-approved kit could allow for testing without a pap smear or pelvic exam.
- The shift is among medical innovations aiming to curb the rising number of early-onset cancers.
People will soon be able to collect their own samples for cervical cancer screening, according to a major new update to the American Cancer Society's screening guidelines.
It's the biggest shift in cervical cancer prevention since HPV testing became the preferred alternative to routine pap smears in 2014.
The new guidance allows patients to swab themselves to test for human papillomavirus (HPV), a sexually transmitted infection that is the primary cause of cervical cancer.
Cervical rates are rising, particularly in younger people, and screening has declined in recent years.
The hope is that this change — part of a broader trend in healthcare making preventive care simpler — will help to catch more cases by speeding up screening.
While the American Cancer Society (ACS) does not dictate federal screening rules, its guidelines are widely used by oncologists and health systems, often paving the way for formal policy changes.
New technology is helping cancer screening to "evolve," said Dr. Robert Smith, senior author of the report and epidemiologist at the ACS.
"These updated recommendations will help to improve compliance with screening and reduce the risk of cervical cancer," Smith said in a press release.
Screening is crucial for cancer prevention
Cervical cancer is among the most preventable — and treatable — types of cancer, thanks to HPV vaccinations and routine screening. But rates of both have dropped in recent years, in part because the COVID-19 pandemic disrupted access to preventive care.
Until recently, HPV screenings meant booking an appointment with a clinician to collect a sample and do a pelvic exam.
That shifted in 2024, when the FDA green-lit testing for self-collected samples, initially in healthcare settings like primary care offices or mobile health clinics. This year, the agency went a step further, approving at-home test options with tele-health support.
Research suggests the testing results for self-collected samples are on par with those collected by physicians when it comes to screening for HPV. Some data found they're slightly less accurate, which is why some doctors still prefer clinical samples when possible, according to the ACS.
Still, having an alternative to pelvic exams could increase HPV screening for people who may find it hard to get an appointment due lack of insurance, long wait lists, or logistical hurdles like scheduling, transportation, or childcare.
Self-collection could also increase testing rates for people who may find a pelvic exam intimidating or uncomfortable, whether due to past trauma, medical anxiety, or simply personal preference.
In Australia, where self-collection for HPV became widely available in 2022, rates of cervical cancer have declined, and screening has increased among patients who had previously not been tested.
How it works
Kits for self-collecting samples for HPV testing are available now via prescription from your doctor (or in some cases, through a virtual appointment, depending on what state you live in).
Using the kit is fairly straightforward: you use a device that looks like a large Q-tip or tampon to swab the vagina for a sample, then send that sample to a lab for screening. If the results are negative, you don't need to get an in-person Pap smear.
For certain abnormal results, the next step may be a clinician-collected sample, or another HPV screening in one to three years, according to NIH guidelines.
The current guidelines recommend starting cervical screening at age 25 for people of average risk, and that HPV testing be done every five years through age 65. The full screening guideline updates were published in the American Cancer Society's CA: A Cancer Journal for Clinicians.