HPV self-swabbing: A new option for cervical cancer screening

A friend recently had a clinic visit and shared with excitement that they were offered the option of doing a HPV self swab test for cervical cancer screening. They wondered why they had never been offered it before. HPV self-swabbing is an emerging option in the U.S. that has the potential to expand cervical cancer screening.

What is HPV self-swabbing?

Why hadn’t my friend been offered that option before? Well, human papillomavirus (HPV) self-swabbing is new in the U.S. In May 2024, the FDA approved two lab tests that allow patients to collect their own vaginal samples for testing while at the clinic. In February 2025, the first U.S. guidelines for self-collected HPV screening came out.

While it’s new here, HPV self-collection has already been offered for years in Australia and Europe. It can be a great option for people with cervixes who delay or avoid screening because speculum exams feel uncomfortable, painful, or even impossible. This can be common for people with: a history of trauma, gender dysphoria related to their genitals, vaginal problems like vaginismus or vaginal stenosis, disabilities, certain medical conditions, or spiritual and cultural practices and beliefs.

The best part? Studies have shown that self-collection is just as good as clinician collection at finding high risk HPV and cell changes that can increase the risk of cervical cancer in the future.

Quick refresher: What is HPV?

HPV is extremely common; 80-90% of people will have this virus at some point in their lifetime. Most people clear it within two years thanks to their body’s immune system. For this reason, I often describe it as a “sexually transmitted cold” when I counsel patients.

There are over 200 types of HPV, but some types are higher risk for cervical and other HPV-related cancers. Together, types 16 and 18 cause about 70% of cervical cancers. High risk HPV can cause changes in cervical cells (cervical intraepithelial neoplasia or CIN), which, if left untreated, may develop into cervical cancer. CIN is graded levels 1-3 based on how deep the abnormal cells go, with 1 being “mild changes” and 3 being “severe changes.”

Ways to prevent HPV

If this all feels overwhelming, start with prevention basics:

• Get fully vaccinated against HPV.
• Avoid smoking tobacco products.
• Use barrier methods like condoms or internal condoms when possible.

HPV is almost entirely transmitted through skin-to-skin contact, so consistently using barrier methods can significantly reduce HPV transmission. Just keep in mind that these methods don’t cover all skin-to-skin contact. And because sex toys can possibly transmit HPV, use condoms if you’re sharing them.

Why is cervical cancer screening important, and when do I need it?

Cervical cancer screening helps catch cell changes early, before they become cancer. It’s recommended that most people start cervical cancer screening between ages 21-25. If you are living with HIV or another condition that affects your immune system, talk to a provider about starting earlier.

One difference between self- and clinician-collected HPV testing is how frequently the test is done. It’s recommended to repeat a normal self-test every 3 years, while a normal provider-collected test is repeated every 5 years. This may change as more long-term data becomes available.

What happens if the self-swab is positive for HPV?

If a self-collected test comes back positive for high-risk HPV, your next steps will most likely be:

• Return to the clinic for a speculum exam where the provider does a different kind of quick test where they take a sample of cervical cells for the lab to examine it under a microscope (this is called cytology, or a pap). Only a health care provider can do this type of testing because the cervix needs to be looked at to take cervical cells. That’s why the self-collection is a vaginal not cervical sample.)

OR

• If it’s type 16 or 18, it’s recommended that you get a colposcopy immediately, where a health care provider looks at your cervix using a high-powered microscope and takes small skin samples via biopsy if there are any unusual-looking spots.

Who shouldn’t self-swab for cervical cancer screening?

While HPV vaginal self-swabbing is safe and effective, it’s not for everyone. It’s not recommended for people living with HIV, people whose gestational parent took the medicine diethylstilbestrol (DES) while they were in utero, and people who need screening under 25 years old. It’s also not recommended if you are currently menstruating, have used any kind of vaginal product in the last 48 hours, have any vaginal or pelvic symptoms (bleeding, discharge, pain, etc.), or any history of abnormal paps or HPV.

How do you do an HPV self-swab?

Collecting your own sample is actually pretty simple:

1. Your clinician gives you one of the approved test swabs.
2. You hold the swab about 3-4 centimeters down (about the length of your pinky finger).
3. Get in a comfortable position for collection (standing, squatting, or lying down all work).
4. Insert the swab almost all the way to where your fingers are holding it.
5. Rotate the swab 4 times for about 20 seconds, gently touching the sides of the vagina.
6. Remove the swab, put it back into the tube, cap it, and you’re done.

Can I do an HPV self-swab at home?

For now, there is only an in-clinic option for self-collection that is covered by insurance. At-home testing kits exist but are expensive and not yet covered by insurance. But in the future, at-home self-collection tests that you can mail to the lab will hopefully be more widely available.

You’ve got options for cervical cancer screening

If it’s been a few years since your last cervical cancer screening, or you’re unsure, check in with your provider. If you would prefer to self-swab, ask them if they offer either of the two approved tests. If they don’t, it’s likely very easy for them to work with their lab to get what they need so that they can start offering them. Or maybe you don’t want to swab yourself, and you don’t want a speculum exam, but you would be okay with your provider doing the vaginal HPV swab. The most important thing to know is that you’ve got choices. Pick the screening options that works for you.