Barbara Levy, MD: Patient-collected hrHPV testing is "huge" part of updated cervical cancer guideline

Self-collected HPV testing could fundamentally change who gets screened for cervical cancer, according to Barbara Levy, MD, FACOG, FACS, clinical professor of obstetrics and gynecology at George Washington University School of Medicine and chief medical officer at Visana Health.

Building on recently finalized HRSA-supported Women’s Preventive Services Guidelines that designate high-risk human papillomavirus (hrHPV) testing as the preferred screening method for most average-risk women aged 30 to 65 years, Levy said the most profound impact may be on patients who have historically avoided care altogether.^1,2

“This is huge,” Levy said. “In my over 40 years of practice in ob-gyn, the patients that I’ve had who had cervical cancer were people who never got screened.” In her experience, the reasons for avoiding screening are often not about access to information, but about the exam itself.

“When you think about what the barriers to screening are, one of them is having to undergo a pelvic exam. Whether it is stigma about your weight or it’s that you were sexually assaulted, and the whole concept of having anybody down there doing anything is so horrendous that you won’t go in,” she said. “So the risk of having a pelvic exam keeps women from seeking ob-gyn care.”

Under the updated HRSA-supported guidelines, patient-collected hrHPV testing is now explicitly recommended as an appropriate option for cervical cancer screening in average-risk women aged 30 to 65 years. The guidance also clarifies that follow-up testing needed to complete the screening process—such as cytology, biopsy, colposcopy, extended genotyping, or dual stain testing—must be covered without cost sharing by most non-grandfathered insurance plans.

WATCH MORE: Barbara Levy, MD, reacts to HRSA's updated cervical cancer guidelines

For Levy, self-collection represents an opportunity to reach patients who have long been missed by traditional screening approaches. “What I really would love for my colleagues to understand is this is an opportunity now to get to that population of people and not threaten them with a pelvic exam,” she said. “Make it clear to them, you can be seen in my practice, and we can do all the things, or most of the things, we need to do without putting your legs up in stirrups.”

Levy framed self-collection not only as a clinical update, but as a shift in how clinicians think about patient autonomy. “This opens up the opportunity to screen people who would not be screened otherwise,” she said. “It gives women agency and autonomy over their bodies.”

“We’ve had self-collection for STI screening in the past already, and so can we get over ourselves and get over our routines,” Levy said, “and be able to offer women this chance to do a test that’s every bit as sensitive when it’s self-collected, because it’s an entirely different test.”

Unlike cytology-based Pap testing, hrHPV screening does not require sampling cervical cells.

“It’s not like I have to get cells from inside the cervix now,” Levy said. “All I have to do is get enough fluid, get enough content, to be able to test for the virus, which is a very different kind of test.”

References:

1. Update to the women’s preventive services guidelines. Health Resources & Services Administration. Federal Register. Published January 5, 2026. Accessed January 22, 2026. https://www.federalregister.gov/documents/2026/01/05/2025-24235/update-to-the-womens-preventive-services-guidelines
2. Fitch J. HRSA updates cervical cancer screening guidelines. Contemporary OB/GYN. Published January 13, 2026. Accessed January 22, 2026. https://www.contemporaryobgyn.net/view/hrsa-updates-cervical-cancer-screening-guidelines