Self-collected vaginal specimens for human papillomavirus testing and guidance on screening exit: An update to the American Cancer Society cervical cancer screening guideline

Sep 23, 2026

Uploaded by Jiven

This update expands the 2020 American Cancer Society cervical cancer screening guideline for average-risk women and individuals with a cervix to include self-collection for human papillomavirus (HPV) testing and revised guidance for exiting screening. Self-collected vaginal specimens, a method of primary HPV testing, align with the guideline. For clinician-collected specimens, repeat screening is recommended every 5 years after a negative test; for self-collected specimens, repeat testing in 3 years after a negative result is endorsed for FDA-approved devices and assays, with additional exit criteria for high-risk settings and ages 60–65.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Abstract

Screening update scope

Primary HPV testing with self-collected specimens

Repeat testing intervals after negative results

FDA-approved device and assay combinations

Screening exit recommendations for ages 60–65

DOI: 10. 3322/caac.70041 ARTICLE Self-collected vaginal specimens for human papillomavirus testing and guidance on screening exit: An update to the American Cancer Society cervical cancer screening guideline Rebecca B. Perkins MD, MSc1 | Andrew M. D. Wolf MD2 | Timothy R. Church PhD3 | Elena B. Elkin PhD, MPA4 | Steven J. Skates PhD5 | Ruth D. Etzioni PhD6 | Carmen E. Guerra MD, MSCE7 | Abbe Herzig PhD8 | Richard M. Hoffman MD, MPH9 | Kevin C. Oeffinger MD 10 | Sana Raoof MD, PhD11 | Ya-Chen Tina Shih PhD12 | Louise C. Walter MD 13 | Charnita Zeigler-Johnson PhD 14 | Deana Manassaram-Baptiste PhD, MPH15 | Robert A. Smith PhD15 1Tufts University School of Medicine/Tufts Medical Center, Boston, Massachusetts, USA 2University of Virginia School of Medicine, Charlottesville, Virginia, USA 3Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA 4Department of Health Policy and Management, Columbia University Mailman School of Public Health, New York, New York, USA 5Massachusetts General Hospital, MGH Biostatistics, Boston, Massachusetts, USA 6Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington, USA 7Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA 8Patient Representative, Mathematics Department, Sarah Lawrence College, Bronxville, NY, USA 9Department of Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA 10Department of Medicine, Duke University School of Medicine and Duke Cancer Institute Center for Onco-Primary Care, Durham, North Carolina, USA Abstract This update expands the 2020 American Cancer Society (ACS) cervical cancer screening guideline for average-risk women and individuals with a cervix who are at average risk, to include self-collection for human papillomavirus (HPV) testing and revised guidance for exiting cervical cancer screening. Self-collected vaginal specimens, a method of primary HPV testing, align with the ACS cervical cancer screening guideline. When clinician-collected cervical specimens are used for HPV testing, repeat screening is recommended every 5 years for those with a negative test. For self-collected vaginal specimens, the ACS endorses the following recommendations of the Enduring Consensus Cervical Cancer Screening and Management Guidelines Committee (of which it is a member): (1) primary HPV screening using clinician-collected cervical specimens is preferred, and selfcollected vaginal specimens are acceptable for average-risk individuals aged 25– 65 years; and (2) repeat testing in 3 years is recommended after a negative result on a self-collected HPV screening test. These recommendations apply only to combinations of collection devices and HPV assays approved by the US Food and Drug Administration for HPV testing in a clinical setting or at home. The rationale notes that the use of self-collected vaginal specimens can overcome barriers to screening for many patients, but most patients who test HPV-positive will require extra follow-up steps, and data on long-term, real-world effectiveness | Please see related article: [https://doi.org/10.3322/caac.70047](https://doi.org/10.3322/caac.70047). | | --- | | This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
© 2025 The Author(s). CA: A Cancer Journal for Clinicians published by Wiley Periodicals LLC on behalf of American Cancer Society. | CA Cancer J Clin. 2026;e70041. [https://doi.org/10.3322/caac.70041](https://doi.org/10.3322/caac.70041) wi[leyonlinelibrary.com/journal/caac](leyonlinelibrary.com/journal/caac) 1 of 12 11Department of Radiation Oncology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA 12David Geffen

FAQs

What does this guideline update add to the 2020 ACS cervical cancer screening recommendations?

It expands the 2020 ACS guideline to include self-collection for HPV testing and revised guidance on when and how to exit cervical cancer screening for average-risk individuals.

For self-collected vaginal specimens used for HPV testing, what repeat interval is recommended after a negative result?

The ACS recommends repeat testing in 3 years after a negative self-collected HPV screening test.

What requirements determine eligibility to discontinue screening at older ages?

Discontinuation at ages 60 and 65 years requires negative primary HPV tests (preferred) or negative co-testing (acceptable), and if those are unavailable, three consecutive negative cytology tests are acceptable with the last test at age 65; self-collected specimens require following the 3-year interval.

Sep 23, 2026

Uploaded by Jiven