Women at average risk for cervical cancer can avoid unpleasant tests in doctors' offices and instead safely test themselves at home for the virus that causes nearly all cases of the disease, the American Cancer Society said on Thursday.
The first at-home screening test for the human papillomavirus (HPV), made by Teal Health and approved in May by the US Food and Drug Administration, uses a vaginal swab, avoiding the traditional speculum-based exam done in the clinic. Women send the swabs to a certified lab for testing.
At least partly because speculum exams can be uncomfortable or even painful, “half of the women in the US who have cervical cancer did not undergo a screening test in the past 10 years," Dr. Diane Harper of the University of Michigan, who has studied the effectiveness of the vaginal swabs, said earlier this year.
The new guidelines, published in CA - A Cancer Journal for Clinicians, will help improve compliance with screening and reduce the risk of cervical cancer, co-author Dr. Robert Smith, senior vice president of the ACS, said in a statement.
Speculum exams are preferred, but self-collected vaginal specimens are acceptable, the updated recommendations say.
When self-collected specimens are HPV-negative, repeat screening in three years is recommended, while negative speculum tests should be repeated every five years, the ACS says.
The ACS advises average-risk patients to initiate cervical cancer screening at age 25 and undergo testing for high-risk HPV strains – so-called primary HPV testing - every five years through age 65. At that point, screening can stop, as long as the last few tests have been negative.
While cervical cancer screening programs have decreased the incidence of the disease by more than half since the mid-1970s, more than 13,000 cases will be diagnosed in the U.S. this year and more than 4,000 people will die from the disease, the ACS says.
A vaginal swab test by Roche for use by patients in doctors’ offices was approved in May 2024.
The guideline authors note that HPV vaccination, such as with Merck's Gardasil, before age 17 is linked with a 90% reduction in the risk of cervical cancer.
