New cervical cancer screening guidelines

As an OB-GYN, what are your thoughts on the importance of these updated guidelines from HRSA and ACOG and draft  USPSTF recommendations for HPV primary screening and HPV self-collection?

It’s wonderful to see all of these entities on the same page. They clearly and collectively have put their support behind HPV primary screening, HPV self-collection, while also including dual stain technology as an option in the downstream screening process.  As an OB-GYN, I was thrilled to see ACOG adopt the HRSA guidelines because clinicians look more to ACOG when making decisions about how to practice.  The ACOG guideline sends a signal that there is significant evidence to support HPV primary screening and self-collection, giving the medical community the added confidence to incorporate HPV primary screening and HPV self-collection as part of their patient care.

HRSA guidelines are critical because, in addition to providing evidence-based federal recommendations, they serve as a primary authority — alongside entities like the USPSTF — in determining which preventive services private health insurers must cover with no cost-sharing (zero-dollar copay) under the Affordable Care Act.
 

What are the most impactful parts of these health policies?

ACOG, HRSA and USPSTF draft  guidelines prefer HPV primary screening as the most effective method  over co-testing and the Pap smear for 30- to 65-year-olds because of HPV primary screening’s higher sensitivity and the  greater assurance that a negative result indicates minimal risk for developing cervical cancer in the near future.  This high negative predictive value can then allow for a safe and longer screening interval of five years, which is longer than the three-year interval for the Pap test alone. Also, the USPSTF draft guidelines found that results are in strong agreement for HPV testing regardless of whether a patient or a clinician obtains the sample. In multiple studies, HPV self-collected samples have shown strong agreement with clinician-collected samples.

While HPV primary screening has been approved by the FDA since 2014, practices have been gradual in their adoption and implementation. It is important to use only FDA-approved tests that are validated for HPV primary screening. These policy recommendations follow those made by the American Cancer Society supporting both primary HPV screening and HPV self-collection.  Hopefully, this is another important step that gives clinicians the assurances they need to move forward to the next level of screening which has been robustly studied.
 

Will adoption of HPV self-collection provide greater access to patients?

It already has in many countries that have incorporated self-collection into their national programs, like Australia, Sweden and the Netherlands. HPV self-collection has the potential to greatly improve screening rates by allowing women and people with a cervix  to collect their own samples privately in a healthcare setting, such as at their doctor’s office, an urgent-care setting or a mobile clinic. At some point in the future, it will be more common for women to take a sample from wherever they are.

Think of all the people who can't get a speculum exam with a clinician. Some women live far away from clinicians who conduct these exams or they don’t have access to transportation to take them there.  Others may be less trusting of clinicians and medicine in general.

Because the process involves women’s intimate areas, it may cause some women embarrassment or it may conflict with their cultural beliefs. Others may have traumatic sexual experiences that prevent them from getting screened. We have an opportunity to increase rates if these women are given another option that removes their barriers.

How could adoption of HPV self-collection contribute to a practice improving its key performance indicators for  value-based care arrangements?

HPV self-collection can improve access and potentially reach the 28%¹ of the population who have never been screened. We know that half² of all cases of cervical cancer diagnosed in the U.S. are in people who have never been or are infrequently screened. Expanding cervical cancer screening options — such as self-collected HPV testing^3,4 — has been shown to increase participation among underscreened populations, helping providers close screening gaps and improve performance on HEDIS quality measures. Patients screened through HPV self-collection count as patients screened under HEDIS quality metrics, which allows clinicians to reach previously unscreened patients, and supports their efforts to improve cervical-cancer rates and boosting quality metrics.

How does this guidance impact health insurance coverage?

The update to the HRSA cervical cancer guidelines in January 2026,  required health insurers to cover HPV self-collection without cost sharing for most health plans. This also includes any additional testing conducted as part of screening, such as dual-stain testing, which is a big change from current practice. This is a big win for patients who have an abnormal screen and for the clinicians caring for them. No one should have to choose between their health and paying the bills.
 

Why are these guideline changes important in eliminating cervical cancer?

We believe through innovations like HPV primary screening and the expanded access enabled by HPV self-collection, combined with education, awareness and advocacy efforts, we can change the course of this disease. We can help save lives and eventually eliminate cervical cancer. 

Roche’s goal is aligned with the World Health Organization’s “90-70-90” targets to help eliminate cervical cancer as a public health problem by 2030. Specifically, these targets are that 90% of girls are fully vaccinated with the HPV vaccine, 70% of women are screened with a high-performance test and 90% of women identified with cervical disease get access to treatment.  

All of these targets are linked. Prevention with the vaccine and early detection are the first step, but we need to reliably and consistently link those who have been identified to be at highest risk to get treatment and care. When the cancer is detected early, 91% of people with cervical cancer have at least a five-year survival rate.⁵

It is encouraging to see  recommendation changes that support a shift to HPV screening technologies that could have a positive impact on women’s empowerment, their health, and getting closer to making cervical cancer a disease of the past.

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