New screening option lets some women skip a pelvic exam

New federal guidelines for cervical cancer screening might make Pap smears a lot less common.  

The Health Resources and Services Administration (HRSA) now recommends a high-risk HPV (hrHPV) test as the preferred cervical cancer screening for women 30 to 65 years old. Even bigger news: Women can collect the vaginal sample themselves without needing an in-office Pap smear or pelvic exam – an exam that makes many women skip the screening altogether. A Pap smear involves a health care provider collecting a sample of cells from your cervix to detect the presence of cervical cancer. 

The new option is only suitable for women 30 to 65 years old that are at average risk for cervical cancer. Women ages 21 to 29 years old should still get a Pap smear every three years.   

The HPV test, also recommended by the American Cancer Society, is even more sensitive at detecting HPV than the Pap smear. It’s performed by swabbing the vagina and leaving the sample at a doctor’s office or by using certain FDA-approved kits at home.  

If results are negative, most women in the designated age range won’t need another do-it-yourself test for five years. Some self-collection programs might require an additional test in three years. Private insurance companies will be required to cover this screening method beginning Jan. 1, 2027. 

“Self-collection can be beneficial for patients with poor access to care or for those who find pelvic exams very challenging,” says Dr. Marie Cabiya, an OB-GYN at Advocate Health Care. “Access to follow-up care is essential for anyone who gets an abnormal result after self-collection. Without adequate follow up, including potential treatment, precancerous results may go on to develop into cervical cancer.”   

But these changes don’t mean women should skip their OB-GYN appointment.  

“While increasing access to care is important, seeing a gynecologist regularly has benefits, such as detection of abnormalities on a physical exam and the ability to address health concerns,” Dr. Cabiya. 

She also says there are strategies gynecologists can use to help women who find pelvic exams very uncomfortable. Given that sometimes those women can also have issues with painful intercourse, it’s important to discuss those concerns at a gynecologic visit. 

“Self-collection should not be used by those with a history of HPV treatment or who are undergoing more frequent testing after a recently abnormal Pap,” Dr. Cabiya adds. “Patients should not be on their period when they perform a self-collection.” 

Screening isn’t the only way to lower your risk for cervical cancer. Women can also get vaccinated, practice safe sex and avoid smoking.  

If you have more questions about cervical cancer screening options, schedule an appointment with an OB-GYN. Find one near you: Illinois | Wisconsin