Impact on SGO Members: Healthcare providers can now provide women at average risk who are aged 30-65 a new option to self-collect samples for cervical cancer screening.
On January 5, the Health Resources and Services Administration (HRSA) released updated cervical cancer screening guidelines. They designate high-risk human papillomavirus (hrHPV) testing, either administered by a patient or by a clinician, as the preferred screening method for women at average risk who are aged 30 to 65 years, while retaining the option for cervical cytology (Pap) testing. For average-risk women ages 21-29, cervical cancer screening using cervical cytology (Pap) is recommended.
Key Updates in HRSA Cervical Cancer Screening Guidelines
- Preferred Method: High-risk HPV (hrHPV) testing is now the preferred screening method for women aged 30–65 at average risk.
- Self-Collection Option: Women in this age group can now self-collect samples for hrHPV testing, either in a clinical setting or at home.
- Self-collection method does not apply to women at higher risk, including those with HIV, immunocompromised conditions, diethylstilbestrol in utero, or women treated for cervical intraepithelial neoplasia grade 2 or higher within the past 20 years.
- Pap Testing Still Available: Cervical cytology (Pap test) remains an option for women aged 30–65 and is the recommended method for women aged 21–29.
- Insurance Coverage: Starting January 1, 2027, most insurers must cover any additional testing needed to complete screening without patient cost sharing.
Expanded Screening Options Under HRSA Guidelines
The addition of hrHPV self-collection as a screening option mirrors similar guidance from the American Cancer Society and reflects rigorous evidence review confirming that the self-collection method is as effective as clinician collection. However, the new HRSA self-collection method applies only to women at average risk ages 30-65 and does not apply to women at higher risk, including those “infected with human immunodeficiency virus, women who are immunocompromised because of another etiology, women exposed to diethylstilbestrol in utero, or women treated for cervical intraepithelial neoplasia grade 2 or higher within the past 20 years.”
In self-collection, women can use a swab or brush to collect a sample in private, either at a doctor’s office or at home. FDA first expanded approvals in 2024 to allow patients to self-collect samples in a clinical setting, and then approved the first at-home self-collection cervical cancer screening kit in May 2025. Self-collection reduces barriers to cervical cancer screening for women, including those with pain or discomfort with pelvic exams, cultural stigma, a history of trauma in the doctor-patient setting, and logistical challenges. In fact, studies have shown that self-collection can improve screening rates. In a JAMA study published in 2023, mailed kits for self-collection increased screening by more than 14% compared to when people only received educational materials and in-clinic screening reminders.
According to the guidelines, most insurance providers will be required to cover without patient cost sharing for any additional testing needed to complete the screening process for malignancies starting January 1, 2027.
SGO is pleased HRSA explicitly addressed coverage since this was a point we emphasized in our comments. By not only increasing choice and lowering screening barriers, but also removing patient cost sharing, HRSA’s updated guidelines for cervical cancer screening represent a major advance for women’s health nationwide.
You can find the full recommendation document on the HRSA website here.