Cervical cancer screening just got easier. A doctor explains why this change matters

By Katia Hetter, CNN

(CNN) — Cervical cancer is one of the most preventable forms of cancer.

Effective screening can detect precancerous changes years before cancer develops. But more than 4,300 women will die from cervical cancer in the United States this year, according to the American Cancer Society.

That’s why the ACS has changed cervical cancer screening recommendations significantly: For the first time, the group has endorsed people having the option to collect their own samples at home, rather than requiring a clinician to perform the exam.

Screening is so important for cervical cancer because symptoms don’t usually show up until the disease has advanced — and now screening is easier than ever. With self-testing available and approved as a new option, people may want to know if it’s as accurate as in-clinic screening and if it’s hard to do. What if you prefer to have a clinician perform the test? And what else can you do to reduce your risk of cervical cancer?

I spoke with CNN wellness expert Dr. Leana Wen to learn more. Wen is an emergency physician and adjunct associate professor at The George Washington University. She previously served as Baltimore’s health commissioner.

CNN: What is cervical cancer, and how common is it today?

Dr. Leana Wen: Cervical cancer begins in the cells of the cervix, the lower part of the uterus that connects to the vagina. Most cases are due to long-term infection with certain high-risk types of human papillomavirus, or HPV, which is extremely common and spreads through sexual contact. Most HPV infections go away on their own, but when high-risk strains persist, they can cause cervical cells to gradually become precancerous and, over many years, develop into cancer.

In the United States, cervical cancer is far less common than it was decades ago, largely because of widespread screening for precancerous cells. Still, about 13,000 women are diagnosed every year, according to the US Centers for Disease Control and Prevention.

CNN: Why is screening so important, even for women who feel healthy?

Wen: Cervical cancer usually does not cause symptoms until it is advanced. Women can feel completely well while precancerous changes are already developing. Screening is designed to catch those changes early, before cancer forms and when it is easiest to treat.

The two main diagnostics that health care providers rely on are HPV testing and Pap tests. HPV testing identifies the virus that causes nearly all cervical cancers, often years before cell changes would be seen or symptoms appear. Detecting HPV, or finding precancerous cells early through a Pap test, allows clinicians to monitor, treat or remove abnormal tissue and stop cancer from ever developing. That is why screening remains critical, even for women who do not have pain, bleeding or other warning signs.

CNN: What exactly has changed in the cervical cancer screening guidelines?

Wen: The major change is that, for the first time, self-collection of the HPV sample is an endorsed option. Previously, screening relied on a clinician collecting a swab of the cervix during a pelvic exam, either for a Pap test or for HPV testing or both.

Under the updated recommendations, women can collect their own vaginal sample for HPV testing in certain circumstances. This change reflects growing research showing that HPV testing is highly effective at identifying women at risk for cervical cancer and that self-collected samples can reliably detect high-risk HPV. Patients opting for self-testing should make sure that they use the test ordered by their provider.

It is important to note that the ACS guidelines state the preferred screening option is HPV testing on a sample collected by the health care provider. This step should be done every five years. Self-collected HPV testing is now also offered as an option; if this is chosen, it should be done every three years. Another option is doing both an HPV and a Pap test every five years at your doctor’s office. And if none of the other options is possible, women also can receive a Pap test every three years.

CNN: Who is eligible for self-collection?

Wen: Self-collection is intended for women who otherwise meet criteria for cervical cancer screening based on age and health history. In general, this applies to women 25 and older who are due for screening and do not have symptoms suggestive of cervical cancer, such as unexplained vaginal bleeding or discharge.

Self-collection is not meant for women with a history of cervical cancer, certain high-risk immune conditions or prior abnormal results requiring close follow-up. Women should discuss eligibility with a health care provider, since recommendations depend on individual risk factors and prior screening history.

CNN: Is self-testing as accurate as screening done by a clinician?

Wen: Studies have shown that self-collected samples are very good at detecting high-risk HPV when compared to clinician-collected samples. At-home kits offer an important advantage, especially for people who avoid screening due to discomfort or fear of gynecological exams or who face scheduling barriers and other access issues. This is why self-testing kits have been approved by the US Food and Drug Administration and medical expert groups now support this option.

CNN: How hard is it to do self-collection? What about women who prefer a clinician-performed exam?

Wen: For most women, self-collection is straightforward. The process typically involves using a swab or brush to collect a sample from the vagina, following clear instructions provided with the test. It does not require a pelvic exam or a speculum to visualize the cervix.

Women who prefer having a clinician perform the test can and should continue to do so. Regular visits with a gynecologist or other clinician remain important for addressing other aspects of health.

CNN: What else can women do to reduce their risk of cervical cancer?

Wen: Screening is the most important step, but it is not the only one. Vaccination against HPV is extremely effective at preventing the infections that cause most cases of cervical cancer. HPV vaccines are highly protective, approaching 100% prevention of cervical cancer when given before exposure. These vaccines also provide strong protection against other HPV-related cancers and significantly lower the risk of developing genital warts. The CDC recommends HPV vaccination starting at 11 or 12 years. Everyone through age 26 should be vaccinated if they did not receive their full vaccine series when younger.

Avoiding smoking is another preventive step, since tobacco exposure makes it harder for the body to clear HPV infections and increases the likelihood that abnormal cells will progress to cancer. Practicing safe sex can reduce the chance of acquiring high-risk HPV, although it does not eliminate risk entirely because HPV is so prevalent.

The bottom line is that people should stay engaged with preventive care. Vaccination, regular screening and appropriate follow-up are key to cervical cancer prevention.

The-CNN-Wire
™ & © 2025 Cable News Network, Inc., a Warner Bros. Discovery Company. All rights reserved.