If you have a cervix you may have felt a surge of relief — joy, even — when the American Cancer Society (ACS) announced its updated guidelines for cervical cancer screening in December. I know I did.
The organization now allows for a self-collection test for human papillomavirus, or HPV, a sexually transmitted infection that causes almost all cases of cervical cancer, as an alternative to a more traditional clinician-collected test. For some women — including me — this endorsement means that we can finally access this lifesaving screening.
Over the last decade, there have been notable changes in how and when women are screened for cervical cancer. The go-to method used to be the Pap smear, which involves inserting a speculum so that a provider can collect cells from the cervix, the lowest end of the uterus that connects to the vagina. Eventually, in 2020, the ACS began recommending that all women at average risk of cervical cancer start screening at age 25 with a clinician-collected HPV test.
For the patient, the experience was the same for a Pap or HPV test: Your provider would still have you lie on your back with your feet in stirrups, insert a speculum and use a swab to collect a sample of cells from your cervix. As someone with vaginismus — a condition that causes my vaginal muscles to involuntarily contract — it would have been impossible for me to get these done.
Then, in 2024, the Food and Drug Administration (FDA) approved self-collected HPV tests for use in health care facilities — meaning that women at average risk could opt to do a less-invasive self-swab of their vagina with their provider present. And in 2025, the FDA approved the first at-home tool, a wand made by Teal Health, to screen for cervical cancer, allowing women to collect the sample and mail it to a lab without even needing to visit their doctor. (If you have a personal history of cervical cancer or are at high risk, you may not be a candidate for self-collected testing).
At 26, I was officially overdue for my first screen, so my doctor recommended I try the in-office self-collection test.
What the self-collected HPV test was like
Before self-collection became an option, I would lie on the exam table at my gynecologist’s office, put my legs in stirrups and involuntarily clench at any touch. I was excited to try the self-collection test, but also skeptical that it would work for me.
The self-swabs in the clinic looked manageable and controllable, something I could hold and insert myself. The handle was as narrow as a mascara wand, and the brush at the end was made of flexible plastic bristles that felt soft. Most importantly, it did not need to directly touch my cervix. It was less invasive, without the internal pressure that usually made my body tense. I inserted the swab about two inches into my vagina, rotated it for 30 seconds and then handed it to my doctor, who swirled it inside a vial with liquid solution.
“That’s it?” I asked my doctor once she screwed the cap on the vial. “Is it for sure as accurate as a regular Pap smear?” Yes and yes, she assured me. I was in awe. There was a time earlier in life when my vaginismus made it feel impossible to even insert a tampon — I couldn’t believe I had completed an HPV test.
My doctor mailed my sample to a lab, and I received the results in less than two weeks. My Pap smear came back normal with no signs of HPV. Even better, this meant I did not need to be tested again for another five years.
Amy Banulis, an OB/GYN and associate medical director for Women’s and Maternal/Child Health at Kaiser Permanente in Virginia, said most women will be able to comfortably complete the self-collected test, even if they have vaginismus.
“For those that still do have discomfort, there are relaxation techniques that can be utilized,” Banulis said. These could include progressive muscle relaxation, deep breathing and imagery or visualization. If these tactics don’t make a difference, your OB/GYN can refer you to a pelvic floor physical therapist that may be able to help you with this, Banulis said.
How effective it is compared to a traditional Pap
The experience was so seamless that I actually worried something was wrong. What if I didn’t insert the swab high enough? I wondered when I got home. Would the results of the test still be reliable if, God forbid, I did not rotate it long enough? It almost felt too comfortable, so how effective was it really? Many women share the same concerns, but they don’t need to worry, said Jasmin Tiro, a professor of public health sciences at the University of Chicago.
Many women who use the test say it’s easy to do and doesn’t hurt, Tiro said, adding: “It’s very hard to do it wrong.”
It’s important to clarify that the self-collected HPV test is not the exact same test as a Pap smear or a clinician-collected HPV test, she said. The self-test collects vaginal cells, while the latter two tests use a sample of cervical cells. While a cervical sample can be tested for both HPV and abnormal cells (cancerous or precancerous), vaginal cells can only reveal if you have HPV, Tiro said.
This means that a self-collected test may be only one part of the screening process, Tiro said. About 10 percent of women will screen positive for HPV, she said. If you get a positive HPV self-collected result, the next step may be a type of test or procedure that involves a pelvic exam to look for precancerous or cancerous cervical cells. That follow-up test is essential for the screening process to be effective, Tiro said.
However, HPV does not always turn into cervical cancer; especially in people in their teens or early 20s, the virus often clears on its own without causing any health issues — which is why screening isn’t even recommended before 25. So depending on your age, your doctor may just want to retest you a few years later to see if you still have an HPV infection and determine then if that warrants further testing.
My takeaway: We need to make screening more accessible
I’m grateful for testing that is less invasive and painful, but I still find myself wondering why it took so long for us to arrive here. How many women would have been protected if our pain and concerns were not routinely diminished? In the past, I had doctors tell me, “Since you’ve had sex before, the speculum shouldn’t feel intimidating.” I became so used to people, including well-meaning physicians, questioning the validity of my pain. And I felt demoralized that I couldn’t even complete a test that was essential for detecting and preventing a disease that kills about 4,000 women in the U.S. each year.
I also wonder what, if anything, can be done to ensure the new self-swab testing is accessible to all women who want or need it? When I asked Tiro, she told me that gathering more patient testimonials, developing patient-centered guidance for people who may still not want to complete the test and devoting more research to the testing can all help. These are all things that physicians and researchers are actively working on.
Personally, the self-collected HPV test has given me a sudden sense of agency, something I have rarely felt in a gynecologist’s office. My hope is that this alternative option can give other women greater control over their health care, too. Cervical cancer screening is an essential preventive care service. If you have trouble undergoing a Pap smear, ask for the alternative self-collection test. There is no shame, only power, in advocating for your health.
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