New ACS Guideline Endorses Self-Collected HPV Tests for Cervical Cancer Screening

The American Cancer Society (ACS) released updated cervical cancer screening guidelines that introduce self-collection of vaginal samples for human papillomavirus (HPV) testing as an option for individuals at average risk and provide new recommendations on when screening can be discontinued. The guideline update, published in CA: A Cancer Journal for Clinicians, reflects advances in screening technology and evolving evidence around accessibility and prevention.

According to ACS, the revised recommendations aim to reduce cervical cancer incidence and improve adherence to screening. In 2025, approximately 13 360 cervical cancer cases are expected in the US, and 4320 deaths are projected to occur, with persistent racial and socioeconomic disparities contributing to disease burden.

Updated Screening Recommendations

ACS continues to recommend that average-risk women and individuals with a cervix initiate cervical cancer screening at age 25 and undergo primary HPV testing every 5 years through age 65. When primary HPV testing is not available, screening may be performed with:

• Co-testing (HPV test + cytology) every 5 years, or
• Cytology alone every 3 years.

The most notable update is the inclusion of self-collected vaginal specimens as an acceptable option for primary HPV testing. Clinician-collected cervical specimens remain the preferred method, but self-collection may be used in the screening setting. If a self-collected specimen tests HPV-negative, ACS recommends repeat testing in 3 years.

Guidance on Exiting Screening

ACS now recommends discontinuing screening at age 65 for average-risk individuals who have adequate negative prior testing. Acceptable criteria include:

• Negative primary HPV tests or negative co-tests at ages 60 and 65, or
• When primary HPV or co-testing is unavailable, 3 consecutive negative cytology tests at the recommended interval, with the final test performed at age 65.

Rationale for the Updates

ACS reports that the guideline changes reflect ongoing review of emerging evidence. Recent FDA authorization of HPV self-collection contributed to the updated recommendations, supporting self-collection as a safe and effective option for broadening access to screening.

Cervical cancer incidence has decreased by more than half since the mid-1970s due to screening programs. However, disparities persist, particularly among individuals in rural regions. ACS notes that over 46 million people (14% of the US population) live in rural areas where long travel distances may limit access to preventive care. Self-collection is identified as a strategy to address screening barriers in underserved populations.

Populations for Whom Screening Is Not Recommended

ACS does not recommend cervical cancer screening for:

• Individuals younger than 25 years of age.
• Individuals older than 65 years of age with adequate prior negative screening and no high-risk conditions.
• Individuals who have had a hysterectomy with removal of the cervix, unless they have a history of high-grade precancerous lesions.

Additional Efforts to Reduce Cervical Cancer Burden

ACS highlighted the National Roundtable on Cervical Cancer (ACS NRTCC), launched in 2022, which aims to improve prevention and screening uptake and address health disparities. The American Cancer Society Cancer Action Network (ACS CAN) is also working to expand access to screening and follow-up care at the policy level.

The updated guideline is accompanied by a patient-facing summary published in the CA journal’s Patient Page series, designed to support shared decision-making and improve patient understanding of available screening options.

References:

1. Perkins RB, Wolf AMD, Church TR, et al. Self-collected vaginal specimens for human papillomavirus testing and guidance on screening exit: An update to the American Cancer Society cervical cancer screening guideline. CA Cancer J Clin. 2026 Jan-Feb;76(1):e70041. doi:10.3322/caac.70041
2. American Cancer Society Updates Cervical Cancer Screening Guideline: Major Changes Include Self-Collection for HPV Testing and Guidance on Exiting Screening. News release. American Cancer Society. December 4, 2025. Accessed December 4, 2025. https://www.prnewswire.com/news-releases/american-cancer-society-updates-cervical-cancer-screening-guideline-major-changes-include-self-collection-for-hpv-testing-and-guidance-on-exiting-screening-302632764.html