Many women dread going to the doctor to be screened for cervical cancer, a process that involves a pelvic exam that can be uncomfortable, painful or, in some cases, even traumatic.
Now, women have another option.
For the first time, a federal health agency’s cervical cancer screening guidance includes an option for women to collect their own sample, either in a health provider’s office or at home. The guidelines from the Health Resources and Services Administration (HRSA) were published today in JAMA.
Doctors “are hopeful this new screening option will increase screening rates and save lives,” said Ann Sheehy, MD, senior author of the JAMA article and chief medical officer and director of HRSA’s office of planning, analysis and evaluation.
Tests will be covered by insurance
The new guidelines are geared toward women at average risk of cervical cancer, which was diagnosed in more than 13,000 US women last year and killed more than 4,300.
Self-collection involves swabbing the vagina, then sending specimens to a lab to test for high-risk strains of human papillomavirus (HPV), which causes almost all cases of cervical cancer.
Unlike COVID-19 tests, which provide rapid results, home testing kits for HPV must be mailed to a lab. Research has shown self-collection to be as effective as cervical cancer screening by a health provider, according to the guidance from HRSA.
In an average‐risk screening population, 10% to 15% women screen positive for HPV, said Robert Smith, PhD, senior vice president of early cancer detection science at the American Cancer Society. In some cases, medical providers may order follow-up procedures to test for cancer.
Insurance plans will be required to cover the full cost of self-collected HPV screenings by Jan. 1, 2027, with no cost to consumers, including follow-up tests, according to HRSA, part of the US Department of Health and Human Services (HHS).
HRSA is one of three federal bodies whose health recommendations are required to be covered by insurance, per the Affordable Care Act. The two other groups are the US Preventive Services Task Force and the Advisory Committee on Immunization Practices, which advises the Centers for Disease Control and Prevention.
The American Cancer Society, which updated its cervical cancer screening guidance in December, also now includes an option for self-collection.
The updates were made possible by recent approvals from the Food and Drug Administration (FDA), Smith said.
In 2024, the FDA greenlit the first testing kit allowing women to collect their own vaginal sample in a clinician’s office. In 2025, the agency approved the first home test.
The number of home-based tests has increased dramatically in recent years. Although some of the best-known products authorized by the FDA are flu and COVID-19 tests, the agency also has approved over-the-counter tests for sexually transmitted diseases such as chlamydia, gonorrhea, and trichomoniasis. Home tests for colorectal cancer have been available by prescription since 2014.
Self-collection could improve screening rates
In the new guidance, Sheehy and her coauthors wrote that “numerous studies have demonstrated the potential for self-collection to increase screening rates, including in historically hard-to-reach populations.”
Many women don’t receive recommended screenings. The percentage of US women screened for cervical cancer fell from 47% in 2019 to 41% in 2023, according to a study published last year.
Cervical cancer screening levels are especially low in rural areas, where women may have to drive long distances for gynecologic exams. Rural women are 25% more likely to be diagnosed and 42% more likely to die from cervical cancer than women who live in cities.
Self-collection has other benefits, officials wrote, including increased privacy and convenience for women, especially for women without reliable transportation.
In addition, the JAMA article notes that self-collection “may also help increase screening by making the process less uncomfortable and more accessible, especially for women in rural areas or those facing transportation or scheduling barriers.”
