ACOG Endorses Patient-Collected HPV Testing for Cervical Cancer Screening

Today, the American College of Obstetricians and Gynecologists (ACOG) released updated guidance on cervical cancer screening that includes a significant new option: patient-collected high-risk human papillomavirus (hrHPV) testing. This marks the first time ACOG has endorsed self-collection for HPV screening, aiming to improve access for underserved populations who face barriers to traditional clinic-based screening.

The updated Committee Statement 28: “Screening for Cervical Cancer” aligns with recommendations from the Health Resources and Services Administration’s Women’s Preventive Services Initiative. It now allows average-risk patients aged 30–65 years to collect their own samples for hrHPV primary screening every three years, provided they prefer this method and appropriate clinical infrastructure is in place for follow-up care.

Addressing Disparities in Cervical Cancer Screening

ACOG leadership emphasized that underscreening remains a critical driver of preventable cervical cancer cases and deaths. “Too many people in the United States are needlessly suffering from cervical cancer. Underscreening—and lack of screening—is the most significant contributor to the development of this largely preventable illness,” said ACOG President Steven J. Fleischman, MD, MBA, FACOG.

Disparities in screening rates persist among women with lower incomes, limited education, and those without health insurance. Christopher Zahn, MD, FACOG, ACOG chief of clinical practice, noted that patient-collected testing offers a tool to reach historically underserved communities but must be paired with proper counseling and infrastructure to ensure effective follow-up.

Current Cervical Cancer Statistics in the United States

According to the American Cancer Society, approximately 13,490 new cases of invasive cervical cancer are projected for 2026, with about 4,200 deaths expected. The Centers for Disease Control and Prevention (CDC) reports that in 2022, 12,960 new cases were diagnosed and 4,162 women died from cervical cancer in 2023.

While cervical cancer death rates have declined since the 1970s due to screening and prevention efforts, disparities remain. The CDC notes that death rates are highest among non-Hispanic Native Hawaiian and Other Pacific Islander women, and incidence rates are elevated for non-Hispanic American Indian/Alaska Native and Hispanic women.

How Patient-Collected HPV Testing Works

Under the new guidance, patients collect their own vaginal sample using a simple swab or brush device in a private setting, such as a clinic bathroom or at home if part of a structured program. The sample is then sent to a laboratory for hrHPV testing, which detects the virus strains responsible for most cervical cancers.

Clinicians are advised to offer this option only when patients express a preference for self-collection and when systems are established to ensure timely result communication, documentation, and referral for further evaluation if the test is positive. The guidance does not replace clinician-collected screening but provides an alternative to increase accessibility.

The Importance of Regular Screening

Regular cervical cancer screening—whether through Pap tests, HPV tests, or co-testing—remains essential for detecting precancerous changes early, when treatment is most effective. The CDC highlights that screening reduces cancer incidence, mortality, and associated healthcare costs. Programs like the National Breast and Cervical Cancer Early Detection Program support access for uninsured and low-income women.

Even though self-collected HPV testing expands options, ACOG stresses that any screening method must be part of a comprehensive approach that includes patient education, access to follow-up diagnostic procedures (such as colposcopy), and treatment when needed.

Looking Ahead

ACOG’s updated guidance reflects a broader effort to make preventive care more patient-centered and equitable. By validating patient-collected hrHPV testing as a safe and effective option, the organization aims to reduce preventable suffering from cervical cancer through increased screening participation, particularly among populations that have historically faced obstacles to accessing care.

Patients interested in this screening option should discuss it with their healthcare provider to determine if it is appropriate for their situation and to ensure the necessary support systems are available for follow-up care.