More Than 7 in 10 US Women Open to HPV Self-Collection for Cervical Cancer Screening, New Study Shows

More than 7 in 10 US women aged 21 to 49 years were open to self-collection for human papillomavirus (HPV) testing for cervical cancer screening, according to findings presenting during a late-breaking abstract session at the 2026 ACOG Annual Clinical & Scientific Meeting (ACSM) being held May 1-3 and simultaneously published in Obstetrics & Gynecology.

In a nationally representative cross-sectional analysis of data from the National Survey of Family Growth, investigators found that 42.9% of eligible US women preferred HPV self-collection, 28.5% preferred clinician collection, and 28.6% had no preference. Together, those who preferred self-collection or had no preference represented an estimated 41.7 million women, or 71.5% of US women aged 21 to 49 years.

The findings come as cervical cancer screening strategies continue to evolve. The study authors noted that approximately 60% of the nearly 13,000 women diagnosed annually with cervical cancer in the United States have not been adequately screened. They also cited access barriers and logistical challenges, as well as embarrassment, anxiety, and discomfort related to pelvic examinations, as factors that may affect screening participation.

The analysis provides timely data for clinicians as HPV self-collection becomes a more prominent screening option. The authors noted that the US Food and Drug Administration approved self-collected vaginal specimens for HPV testing in health care settings in May 2024 and approved the first at-home vaginal sample self-collection device in May 2025.

For primary care physicians, who often help coordinate preventive screening, the findings support HPV self-collection as a potential strategy to improve access among patients who are overdue for screening or face barriers to pelvic examination-based screening. As the authors noted, the results may help inform “implementation strategies to improve access.”

The study included 4465 women aged 21 to 49 years without a history of hysterectomy or cervical cancer who participated in the National Survey of Family Growth from January 2022 through December 2023. The survey used a national, multistage, probability-based sample designed to represent the US household population, with survey weights and design variables applied to generate national estimates.

Respondents were asked whether they would prefer using a simple kit to test for HPV infection themselves rather than having the test performed by a physician or nurse. Those who preferred self-collection or had no preference were then asked whether they would prefer to complete the test at home or in a physician’s office.

Among women who were open to HPV self-collection, 52.1% preferred self-collection at home, 14.7% preferred self-collection in a physician’s office, and 33.2% had no preference for location. The study’s page 4 figure shows that openness to self-collection was higher among women who were underscreened or never screened than among those who were up to date with screening.

Screening status appeared to be an important factor. Among women who were underscreened or never screened, 54.0% preferred HPV self-collection compared with 40.3% of women who were up to date with screening (P<.001). An estimated 9.7 million women who were underscreened or never screened were open to HPV self-collection.

Among women open to HPV self-collection, preference for at-home testing was also higher among those who were underscreened or never screened compared with those who were up to date with screening, at 59.3% vs 50.2%, respectively (P=.001).

Preferences varied across demographic and clinical characteristics. Preference for HPV self-collection differed by race and Hispanic origin, education, income, parity, sexual orientation, and prior experience of nonvoluntary vaginal intercourse. Women who were nulliparous, women who had ever experienced nonvoluntary vaginal intercourse, and women who identified as lesbian, bisexual, or something else more often preferred HPV self-collection and self-collection at home.

Investigators noted that women with lower educational attainment and lower household income have lower cervical cancer screening coverage, but in the current study, these groups were more likely to say they did not prefer HPV self-collection compared with women with higher education and income levels. They suggested that concerns about accuracy and lack of confidence in performing self-collection may help explain these responses.

The study has limitations. The survey excluded women aged 50 years and older, although cervical cancer screening is recommended through at least age 65 years. Data were self-reported, and the survey did not assess the reasons behind respondents’ preferences. The authors also noted that the survey described the self-sampling kit as “easy to use,” which may have influenced responses.

“These findings provide timely evidence to inform future policy decisions and implementation strategies to improve access to cervical cancer screening,” Qin and colleagues concluded.

Check out all the Patient Care ACOG 2026 coverage.

Reference

1. Qin J, Martinez G, Holt HK, et al. Preferences among U.S. women for cervical cancer screening with self-collected specimens for human papillomavirus testing. Obstet Gynecol. 2026;147(3):306-312. doi:10.1097/AOG.0000000000006147