Dr Neff on the Accuracy and Feasibility of Self-Collected HPV Testing in Cervical Cancer

"There's a lot of excitement around this option for the future. [It would be beneficial] for patients to potentially be able to perform these types of self-collected tests, especially if they have difficulty with exams or are not comfortable with sensitive exams. [With this option,] we're not missing those patients within screening windows for cervical cancer.”

Robert Neff, MD, a physician and associate professor of Gynecologic Oncology at the Ohio State Comprehensive Cancer Center—James, discusses evidence supporting the feasibility and accuracy of self-collected HPV testing in cervical cancer, as well as current logistical challenges limiting the adoption of this screening modality, during cervical cancer awareness month.

On January 5, the Health Resources and Services Administration released updated cervical cancer screening guidelines designating hrHPV testing as the preferred screening method for women at average risk between the ages of 30 and 65 years. Critically, these guidelines establish that women in this demographic may now self-collect samples for testing, either within a clinical environment or in a home setting.

Neff began by stating that this shift in focus to HPV screening as the preferred modality has resulted in significant improvements in the detection of both cancerous and precancerous lesions compared with traditional methods. Regarding self-collected HPV tests, clinical studies have shown that this screening method is just as effective as clinician-collected samples at identifying specific HPV variants, Neff asserted. Likewise, self-collected HPV tests are a viable testing alternative for patients who may avoid routine screening due to discomfort or sensitivity regarding physical exams, thereby ensuring they remain within appropriate screening windows.

Despite the clinical efficacy of self-collection, several logistical and professional barriers remain. Neff noted that the lack of a visual clinical exam is a point of concern for many practitioners, as cervical cancer has historically been a disease diagnosed and staged through direct clinical observation. Consequently, the current recommendations for self-collected screens suggest a shorter interval of 3 years between tests, rather than the 5-year window typically allowed for negative physician-collected HPV tests, he explained.

Additionally, at this point in time, self-collected HPV tests still generally require an in-person visit to ensure samples are processed correctly by the clinic, indicating that the technology is not yet ready for home use. However, a major shift in accessibility is on the horizon; beginning January 1, 2027, most private insurers will be mandated to cover self-collected HPV screenings with no cost sharing for the patient. Neff concluded that while the transition presents challenges, the excitement surrounding the future of self-collected testing reflects its potential to significantly improve screening outcomes.