HPV testing at home: A new option for women
The vast majority of cervical cancer cases are caused by human papillomavirus, or HPV. Detecting it is more straightforward than ever.
- Reviewed by Tien Ly, MD, Contributor
Private. Comfortable. Convenient. These probably aren't words most women would associate with cervical cancer screening, which until recently always took place in a doctor's office and usually involved placing our feet in stirrups as part of a pelvic exam.
But now there's another option. In January 2026, the U.S. Department of Health and Human Services (HHS) issued cervical cancer screening guidelines that, for the first time, include an option for women to perform an at-home high-risk HPV (hrHPV) test. It looks for the strains of human papillomavirus, or HPV, which cause about 95% of cervical cancers.
Experts hope the new option will boost the number of women who seek screening and save more lives. In 2026, an estimated 13,490 new cases of invasive cervical cancer will be diagnosed in American women, according to the American Cancer Society, and another 4,200 women will die of the disease.
The at-home hrHPV test is an option for women over age 30 at average risk for cervical cancer. Women with a recent history of an abnormal Pap smear, positive test for HPV, symptoms such as vaginal bleeding or abnormal discharge, or prior treatment of a gynecologic problem should continue to get screened in the office.
"Giving many women the ability to obtain this test at home can potentially increase screening rates. It's already being done successfully in other countries," says Dr. Tien Ly, an OB/GYN at Harvard-affiliated Massachusetts General Hospital.
Shifting focus
Introduced in 2024 as an option within providers' offices, the self-swab test is part of a shifting model of cervical cancer testing in the United States.
For many decades, screening centered on the Pap test. To do a Pap smear, a clinician inserts a long swab into the vagina during a pelvic exam to scrape cells from the cervix. The cell sample is sent to a lab to look for abnormalities.
In recent years, the same sample has also been used to check for HPV; this dual analysis is called a co-test. But scientists have learned that HPV testing alone, which can be accomplished more comfortably by merely swabbing the walls of the vagina, is better at predicting future cervical cancer compared with the Pap component by itself.
HPV comes in more than 200 strains, two of which are responsible for more than 70% of cases of cervical cancer. High-risk HPV tests home in on 14 high-risk strains. "Testing for the high-risk group is better than doing a Pap smear alone," Dr. Ly says, "and doing high-risk HPV testing first is just as effective as co-testing."
Home testing process
To perform an at-home HPV test, a woman parts the labia, inserts a plastic swab (similar in size to a pen), rubs it along the vaginal walls, and removes it. She then immediately places the swab in a vial and sends it to a lab for evaluation. Results should be available within a week.
Studies comparing self-collection with physician-led collection show no difference in accuracy, Dr. Ly says. That's likely due to the ease with which HPV-infected cells can be collected. "HPV is found on the cervix, in the vagina, and on the vulva," she says. "It's everywhere."
Women who test positive for HPV will be guided by their clinicians on follow-up steps, which could include a Pap test or a colposcopy procedure that uses a specialized microscope to examine the cervix and vagina for abnormal cells. Women who test negative for HPV won't have to repeat the test for three years.
Considering self-testing?
Dr. Ly believes more women will seek cervical cancer screening if they can literally take the process into their own hands. A recent analysis casts some doubt on the notion while still providing glimmers of hope.
According to a March 2026 study published in Obstetrics and Gynecology, involving nearly 4,500 women ages 21 to 49, only 43% said they would prefer self-testing, while 28.5% would rather their clinician perform testing. However, 28% said they had no preference, meaning that a total of 71% are at least open to the idea of self-testing, Dr. Ly says.
Notably, about 18% of respondents either had never been screened for cervical cancer or hadn't undergone adequate screening, and 54% of these women indicated they would prefer self-collection. "I think that's the most significant number to focus on, because those are the patients we want to reach," she says.
However, the self-test doesn't negate the need for women to see their gynecologist and undergo periodic pelvic exams, which also check for other conditions, Dr. Ly notes.
Who can stop cervical cancer screening at 65?Cervical cancer screening guidelines recommend women start screening at 21 and can stop at age 65 - if certain criteria have been met. In the prior 10 years, a woman must have had either three negative Pap tests two negative co-tests (HPV and Pap), or two negative high-risk HPV tests, with the two most recent tests occurring between ages 60 and 65. They must also have never been diagnosed with severe dysplasia (abnormalities) of the cervical cells, says Dr. Tien Ly, an OB/GYN at Massachusetts General Hospital. Once she has met those criteria, a woman 65 or older is considered at low risk of cervical cancer. Any older woman with vaginal bleeding, however - regardless of prior test results - should be screened. "Then she's no longer considered at average risk," Dr. Ly says. |
Image: © Carol Yepes/Getty Images
About the Author
Maureen Salamon, Executive Editor, Harvard Women's Health Watch
About the Reviewer
Tien Ly, MD, Contributor
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