Sangini Sheth, MD, MPH, on HRSA guideline updates and the clinical integration of HPV self-collection

In January 2026, the Health Resources and Services Administration (HRSA) finalized updated cervical cancer screening guidelines, which highlighted patient self-collection and reinforced primary high-risk HPV (hrHPV) testing as the preferred method for women aged 30 to 65. Sangini Sheth, MD, MPH, Associate professor, Obstetrics, Gynecology; Division director, Obstetric, Gynecologic specialties; vice chair, Collaborative Excellence, Yale School of Medicine, joined Contemporary OB/GYN to discuss how these evidence-based updates reflect a new era of patient-centered screening.

Expanding access through self-collection

The updated guidance designates primary hrHPV testing every 5 years as the preferred screening approach for average-risk women aged 30 to 65. Central to this update is the inclusion of patient-collected hrHPV testing, which can occur either within a clinical space or at home. Sheth noted that while clinician-collected samples remain an option, self-collection removes the requirement for a speculum exam, a common barrier for many patients.

“The home collection device that is FDA-approved is the Teal Wand,” Sheth stated, noting that patients can access this testing through a website and telehealth platform. She observed that while clinicians may have more familiarity with self-collection occurring in a clinical setting—where a patient uses a small swab in the office—the home-based option is an "innovative breakthrough" for those who have been delaying care. “The guidelines are very much reflecting that these tests have evidence and approvals behind them,” Sheth added.

Removing financial and physical barriers

A critical component of the HRSA update is the requirement for insurance plans to cover the full screening process without cost-sharing. This includes not only the initial self-collected or clinician-collected sample but also necessary follow-up services such as cytology, biopsy, colposcopy, and extended genotyping.

Sheth emphasized that this coverage is essential for ensuring that abnormal results lead to timely intervention.

“The tricky thing that will be really important to track and monitor in the coming months to years is going to be ensuring that we have systems in place for patients who have an abnormal self-collection to be able to get back into the office, or get to the office in the first place, for follow-up,” she said.

Improving screening rates and equity

The updates are expected to improve screening rates by addressing patients who may have never been screened or are behind on their intervals. HRSA noted that self-collection performs comparably to clinician-collected samples for detecting high-risk HPV, offering a powerful tool to reach marginalized populations.

“For clinicians, the hope is that this improves our overall screening rates by addressing patients who may have never been screened or are behind, or patients who may have been delaying screening,” Sheth concluded.

Reference:

Fitch J. HRSA updates cervical cancer screening guidelines. Contemporary OB/GYN. Published January 13, 2026. Accessed March 19, 2026. https://www.contemporaryobgyn.net/view/hrsa-updates-cervical-cancer-screening-guidelines