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Self-collected vaginal specimens are now accepted for cervical cancer screening, according to new guidelines from the American Cancer Society. Clinician-obtained cervical specimens remain preferred.
The American Cancer Society (ACS) on December 4 released updated guidelines for the development of self-collection tools for HPV (human papillomavirus) testing, including important changes and new recommendations for when individuals can safely stop screening for the disease.
These changes follow the Food and Drug Administration’s (FDA) approval of HPV self-collection tests in May. Teal Wand is a home vaginal sample self-collection device used for HPV testing. The wand has a sterile sample ball that is used to swab the inside of the vagina.
“These updated recommendations will help improve screening adherence and reduce the risk of cervical cancer,” said Dr. Robert Smith, ACS senior vice president of early cancer detection science and lead author of the report. The report was published in CA: A Cancer Journal for Clinicians, the flagship journal of the American Cancer Society (ACS).
Studies have shown that long-term infection with certain HPV strains is the cause of virtually all cervical cancers. It’s the most common sexually transmitted disease, but it’s also preventable thanks to Gardasil-9, a vaccine known for its historic reduction in cancer. However, the ACS recommends that average-risk women and those with a cervix begin cervical cancer screening at age 25 and undergo primary HPV testing every 5 years until age 65.
Despite the widespread success of cervical cancer screening programs, the report estimates that 13,360 people will be diagnosed with cervical cancer this year and an estimated 4,320 people will die from the disease in the United States.
Cervical cancer screening guidelines will change
Testing is recommended every 5 years for clinician-collected cervical specimens and every 3 years for self-collected vaginal specimens.
The ACS recommends that ages 60 and 65 years have a negative initial HPV test or a negative concurrent test before discontinuing testing.
Simultaneous testing refers to performing an HPV test and a Pap test together. While a Pap test looks for changes in cells in the cervix, a primary HPV test tests for HPV directly. If primary HPV testing is not available, three negative cytology tests every 3 years are allowed before screening is discontinued. Last test was at age 65.
These guidelines apply to women ages 25 to 65 because cervical cancer rarely occurs before age 25. Women over the age of 65 who follow the guidelines above can safely complete the test. These guidelines also do not apply to women who have had a hysterectomy (which involves removal of the cervix) unless they have a history of high-grade precancerous lesions (abnormal cells that have a high risk of becoming cancerous if left untreated, but have not yet become cancerous).
Self-screening can reduce geographic disparities in cervical cancer
Despite significant progress in reducing cervical cancer, socio-economic and geographic disparities persist.
People who live in rural areas are more likely to be diagnosed with late-stage cervical cancer. In recent years, death rates related to the disease were 42% higher in rural counties than in urban areas, according to a 2025 study published in JAMA.
“More than 46 million people, or 14 percent of the U.S. population, live in rural areas and often need to travel long distances to receive health care,” said Lisa Lacasse, president of ACS CAN. “Self-collection options are an important resource for these individuals and other underserved populations.”
The published guideline report also includes a patient page that answers questions about the disease, associated symptoms, prevention, and treatment.
“This is an important step toward eliminating cancer for everyone as we know it,” Lacasse added.
