There’s a new way to screen for cervical cancer. With self-collection, you can take a sample of cells from your vagina. Your health care provider sends that sample to a lab that tests for HPV, the cause of almost all cervical cancer. You still have to go to your provider’s office, but there’s no pelvic exam, stirrups, or speculum involved. And research shows the results are just as accurate.
Here’s what you need to know about this new option.
There are nearly 14,000 cases of cervical cancer diagnosed in the United States each year and over 4,000 women die from the disease annually. Cervical cancer grows very slowly and can be detected and treated before it becomes cancer. That’s why screening is so important. In fact, over half of cervical cancer diagnosed in the United States occurs in people who’ve never been screened or who have been infrequently screened.
The first test developed to screen for cervical cancer was called the Pap smear after George Papanicolao, the doctor who invented it in the 1940s. Widespread use of the Pap smear, which we now refer to as the Pap test or cytology, brought the rates of cervical cancers down by over 70%.
A Pap test is always done by a health care provider. It is usually part of a pelvic exam. A clinician will insert a speculum to separate the walls of your vagina so they can see the cervix (the bottom part of your uterus). They then use a brush to collect some cells from the cervix. This may feel uncomfortable (some people say the speculum feels heavy), but it usually doesn’t hurt.
These cells are put in a test tube that already has a liquid solution in it and sent to a lab. The cells are examined under a microscope using a process called cytology. This can determine if there are any changes to the cells that might be cancerous or pre-cancerous.
We now know that almost all cases of cervical cancer are caused by the human papilloma virus (HPV). Two types of HPV—16 and 18—cause most cervical cancer. There are other types that are also considered high risk.
Since the early 2000s, the HPV test has been able to look for the presence of specific types of the virus in samples of cells from the cervix. If you test positive for high-risk HPV, it does not mean you have cancer, but you will likely have to have additional tests to look for cancer or precancerous cells.
Until recently, the HPV test was done in much the same way as the Pap test. A provider would use a speculum and scrape the cervix with a brush or tiny spatula. These cells would be sent to a lab for testing.
Often HPV tests and Pap tests are done at the same time and sent to the lab together. This is called co-testing.
During a Pap and/or HPV test, a health care provider inserts a tool called a speculum into the vagina. This helps the provider view and access the cervix. The provider then inserts a brush into the vagina and uses it to take a sample of cells from the cervix. The procedure is typically very quick and should be painless, although possibly slightly uncomfortable. If the speculum feels too uncomfortable, a patient can request that a smaller speculum be used.
As we’ve learned more about cervical cancer and HPV, screening recommendations have changed. The CDC currently says that people under 21 do not need to be screened for cervical cancer at all even if they’re sexually active.
As a patient, you don’t usually get asked which screening method you’d prefer. Your provider makes that call based on their preference, the tests they have access to, and the labs they use. That’s okay, all of these screening methods are effective! Talk to your provider about what screening method(s) they use.
*This schedule may change in 2025. A new set of recommendations were recently released, but they are still in draft form. NCCC will update this page as soon as the newest guidelines are finalized.
If you’re doing an HPV test alone, you may be able to avoid the pelvic exam and speculum.
The FDA recently approved tests that allow you to collect your own specimen from your vagina. That specimen will then be sent to a lab to check for the presence of HPV, and specifically for the high-risk types of the virus that cause cervical cancer.
This test can’t be done at home. You still have to go to a provider’s office, but you do not need a pelvic exam. Instead, your provider will give you a kit that includes a test tube and a brush or swab. You use that to collect cells from inside the upper part of your vagina (you don’t have to find your cervix). Those cells are sent to a lab, and you get your HPV test results within a few weeks.
There has been a lot of research done on self-collection. Study participants found it easy to collect their own samples. And researchers found that the results matched HPV tests done by providers. The tests are just as accurate.
The official recommendations have not yet been finalized, but it is likely that people who use HPV self-collection and test negative will be told to come back in three years. People who have their provider take a sample and test negative for HPV don’t need to come back for five years. (People who get only pap tests are also told to get tested every three years.)
Anyone who tests positive for HPV will have to see their provider for additional tests.
If you test positive for HPV types 16 or 18, your provider will probably ask you to come in for colposcopy (see below). This is the same follow up they would do if a Pap test came back abnormal.
If you did self-collection and test positive for another, lower-risk type of the virus, your provider might have you return to the office for a Pap test. This is one outcome where the procedure is different for self-collection. When a provider collects samples for an HPV test, the same sample can be used for cytology, and you’d only have to re-test if that test comes back abnormal.
Most HPV tests come back negative and no follow-up is required.
If your HPV test comes back positive for types 16 or 18 or your Pap test comes back abnormal, your provider will likely ask you to come back for colposcopy. This is a procedure that looks closely at the cervix with a special lighted microscope (called a colposcope). It is done in a provider’s office during a speculum exam. It does not hurt but may be uncomfortable.
If your provider sees something that looks like it might be cancerous or precancerous, they may cut out a small piece of tissue from the cervix that can be examined more closely in a lab. This is called a biopsy.
Biopsies can pinch or hurt for a few minutes and may cause cramping similar to menstrual cramps. Talk to your provider about what to expect, and what you can do for pain before or after the procedure.
HPV Self-Collection is a great new option for cervical cancer screening. It is easy to do, and lets you avoid a speculum exam which many people find uncomfortable.
Self-collection was only recently approved, but the hope is that it becomes available not just in gynecologists’ offices and women’s health clinics, but in other convenient places like primary care offices, urgent cares, ERs, mammogram facilities, mobile health clinics, and even pharmacies.
The easier we make it for everyone to get screened for cervical cancer, the faster we can meet our goal of eliminating this disease in the United States.
Hear from two experts, Barbara Moscicki, MD, and Jennifer S. Smith, PhD, who have been involved in the research around HPV self-collection for many years. They clearly explain this new method and how it might help us reach the goal of eliminating cervical cancer.
Yes. Researchers have compared HPV tests done with self-collected samples to those done with samples collected by a provider and found that the results are the same.
No. Self-collection is not recommended for people who have any active cervical or vaginal symptoms or have a history of cervical cancer. It is also not recommended for anyone at higher risk of cervical cancer because of immune deficiency (like HIV) or exposure to diethylstilbestrol (DES).
No. The self-collection kit comes with good instructions and is very easy to do. You just need to insert the brush/swab high into your vagina (you do not need to reach your cervix). Your provider may say swirl it five times or rotate it for 20 seconds. Then you put the brush/swab into the test tube that comes with the kit and return the whole kit to your provider. They will take it from there.
Your provider is still responsible for giving you the results of your test. You should get them the same way they normally provide test results—whether that’s by phone, mail, or on a patient portal. If you’re not sure, ask your provider or the office staff before you leave.
Probably. The final recommendations on when/how often to screen for cervical cancer are still in draft form, but it looks like people who use self-collection will be asked to test every three years instead of every five years if a provider collects the sample. Anyone who gets a Pap test is also asked to test every three years.
Yes. If your provider offers self-collection, you can decide whether you want to use that option or if you’d prefer for her to collect your sample.
Not yet. The FDA has only approved HPV self-collection tests for use in a health care setting. This could be gynecologist’s office, an ER, an urgent care, a mobile clinic, or even a pharmacy. But as of now it is not approved for you to use at home. This may change in the next few years.
There are home tests available on the market, but these have not yet been approved by the FDA.
If you have health insurance, cervical cancer screenings should be covered without a co-pay regardless of which method is used. If you are uninsured, the cost will likely be the same as having a provider collect a sample because it is considered the same type of visit.
If you are uninsured and can’t afford health care, you may qualify for a CDC program that offers low-cost cervical cancer and breast cancer screening. See here for more details.
The FDA just approved the Teal Wand, a self-collection device for HPV testing that does not require a speculum exam or even a trip to the doctor’s office. People can collect their own sample at home and send it to a lab for analysis.
The results of large-scale study of HPV suggest that one shot of the vaccine may be enough to protect young people from HPV and related issues like cervical cancer.
You have probably heard that HPV can cause cervical cancer. But did you know that it can also cause cancers of the mouth, tongue, and throat?
There are over 100 different types of human papillomavirus, or HPV. Some types of HPV can cause genital warts and other types can cause cancer, including cancer of the cervix, vulva, vagina, penis or anus, as well as cancer in the back of the throat.
The pandemic interrupted our regularly scheduled doctor’s visits and pushed off preventative care like Pap tests.
A new study has found a dramatic drop in the rates of cervical pre-cancers among young adult women. This is great news and further proof that the HPV vaccine is working.
In the U.S., HPV infections are estimated to cause about 37,300 cases of cancer. The HPV vaccine can prevent over 90% of these cancers from ever developing.
For the second year in a row, HPV vaccination rates among teens have not gone up according to the Centers for Disease Control and Prevention (CDC).
ASHA believes that all people have the right to the information and services that will help them to have optimum sexual health. We envision a time when stigma is no longer associated with sexual health and our nation is united in its belief that sexuality is a normal, healthy, and positive aspect of human life.
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