A major update to federal women’s health preventive guidance will make it easier for women to get screened for cervical cancer, including a self-collection option that allows some women to test themselves at home instead of going to a doctor for a pelvic exam.
The new option will be covered by private insurance beginning in January 2027.
The updated Health Resources and Services Administration (HRSA) guidance now advises that people receive a high-risk HPV test – which checks for the virus types most likely to cause cervical cancer – every five years for average-risk women ages 30 to 65 as the preferred screening approach. This can be done with a clinician-collected sample or by the patient at home.
Practice Nurse/doctor doing smear test
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Women in that age group still have other choices: a combination of an HPV and Pap test every five years, or Pap testing alone every three years if HPV testing isn’t available.
“The addition of self-collection really empowers women to make this choice for themselves,” Ann Sheehy, MD, the HRSA’s chief medical officer, told ABC News. “We do retain the option for Pap smear … this is just an additional choice for women.”
For women ages 21 to 29, the recommendations stay the same: Pap tests every three years, which Sheehy said aligns with available evidence.
“By doing this, we’re going to get some of those people that have been falling through the cracks and not getting this testing done in advance,” Tom Engels, administrator of the HRSA, told ABC News. “And by doing that, we’re going to save lives.”
Engels emphasized that the update is meant to expand testing options, not replace the Pap test. Self-collection is intended to remove barriers for women who find in-office screening difficult to schedule, uncomfortable, or hard to access, he stressed.
American Cancer Society (ACS) guidelines updated in December, by contrast, recommend that cervical cancer screening should begin at age 25 and centers on primary HPV testing, including self-collection tests.
“The combination of good evidence of the benefits of self-collection, which include increased access to cervical cancer screening, combined with FDA approval, led the ACS and HRSA to include self-collection in their guideline update,” Dr. Robert Smith, senior vice president, Early Cancer Detection Science at the American Cancer Society and author of the organization’s updated guidelines, told ABC News.
Cervical cancer screening is often cited as a major public health success. Over the last 50 years, cervical cancer incidence and deaths have fallen by more than 50% in the U.S., according to the American Cancer Society, largely because screening can catch precancerous changes early, before patients notice any symptoms.
UNITED STATES – MARCH 09: Bottles of Merck & Co.’s cervical cancer vaccine Gardasil are arranged for a photo at a pharmacy in New York, U.S., on Monday, March 9, 2009. Merck & Co.’s $41.1 billion purchase of Schering-Plough Corp. adds experimental drugs for blood clots, infections and schizophrenia and allows the companies to speed research on biotechnology drugs. (Photo by Jb Reed/Bloomberg via Getty Images)
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When cervical cancer is found early, five-year survival is higher than 90%, Centers for Disease Control and Prevention (CDC) data suggests. But the HSRA guidance notes that more than half of diagnoses happen beyond the earliest stage, after the disease is spread to other areas of the body. In those later stages, five-year survival is only about 20%, according to the CDC.
Wide use of the HPV vaccine is expected to push cervical cancer rates even lower over time, but most of the historical decline happened before widespread vaccination efforts.
Sheehy said she has seen the consequences when screening doesn’t happen, and why early detection matters.
“I’ve seen women who didn’t have access to screening, and their cancer presented at a very late stage,” she said. “Most women who have early-stage cervical cancer or precancer lesions are asymptomatic, and the only way we’re going to detect that is with screening.”
The updated guidance aims to address stubborn gaps despite the decades of progress, she added, pointing out that about half of women diagnosed with cervical cancer have either never been screened or their screening isn’t up to date, and about one in four women in the U.S. are not up to date with screening, according to the CDC.
Cervical cancer cells.
Science Photo Library – Cnri/spl/Getty Images
Only FDA-approved tests are recommended for self-collection. The FDA first expanded approvals in May 2024 to allow patients to self-collect samples in a clinical setting. In May 2025, the FDA approved the first at-home self-collection cervical cancer screening kit.
The at-home option is available by prescription. Exactly how patients access a covered self-collecting test may vary by insurer and plan.
“There’s some FDA tests that are approved for self-collection in an office-based setting and there is one that is available for self-collection at home,” Sheehy noted.
Sheehy and Smith both added that a positive HPV result is not a cancer diagnosis, but it can mean additional testing is necessary.
The updated guidance also aims to reduce costs that can pile up after an abnormal screening result by clarifying what insurers must cover without cost-sharing, including follow-up testing and diagnostic evaluation such as Pap testing, biopsy, and lab work, depending on individual needs.
A separate HRSA guideline that took effect Jan. 1 also requires insurance coverage for patient navigation services that help women schedule screenings, address care challenges, and follow up after abnormal results.
“We know the health care system is incredibly complicated for patients to navigate,” Sheehy said.
Both Engles and Sheehy emphasized how optimistic they are about the potential benefits of expanding access to cervical screening.
“This could be really, really, game-changing for women,” Sheehy said.
Radhika Malhotra, MD, is an internal medicine-preventive medicine resident at Rutgers New Jersey Medical School and a member of the ABC News Medical Unit.
ABC News’ Liz Neporent contributed to this report.
