Sangini Sheth, MD, MPH, on navigating shared decision-making for HPV self-collection

The Health Resources and Services Administration (HRSA) recently finalized updated cervical cancer screening guidelines, a move that formally introduces patient self-collection and reinforces primary high-risk human papillomavirus (hrHPV) testing as the preferred modality 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 the clinical nuances of implementing these options and the importance of counseling patients on screening intervals.¹

The role of shared decision-making in the clinic

The updated HRSA-supported Women’s Preventive Services Guidelines state that patient-collected hrHPV testing is an "appropriate method" and should be offered as an option for average-risk women. Sheth emphasized that this update necessitates a robust shared decision-making process between clinicians and patients.

“It'll be really important to have these conversations with patients about the options available to them for screening,” Sheth said. She noted that clinicians should provide clarity on the "pros and cons" of each method, whether the sample is clinician-collected in the office or self-collected by the patient at home.

“I do think it's important to talk about both the immediate screening, but also have that conversation about follow-up,” Sheth added, noting that if an initial screening is abnormal, additional services such as colposcopy or biopsy are required to complete the process.

Navigating guideline discrepancies on screening intervals

While the HRSA guidelines align self-collection with clinician-collected primary hrHPV testing—recommending a five-year interval for those aged 30 to 65—Sheth pointed out that other professional bodies maintain different standards. This creates a potential point of confusion for health systems and patients alike.

“The HRSA guideline for even for self collection is recommending a 5-year interval. So essentially the same as if that primary HPV is clinician-collected,” Sheth explained. However, she noted that other guidelines, including those from the American Cancer Society (ACS) and ASCCP, currently recommend a more conservative 3-year interval for self-collected samples until more long-term data is available.²

“As a practice or a health system, coming to a decision about which interval will be followed when, for the self-collected samples, will be important so patients have clarity,” Sheth suggested.

References:

1. Fitch J. HRSA updates cervical cancer screening guidelines. Contemporary OB/GYN. Published January 13, 2026. Accessed March 20, 2026. https://www.contemporaryobgyn.net/view/hrsa-updates-cervical-cancer-screening-guidelines
2. ASCCP Practice Advisory: Self Collection for Cervical Cancer Screening
   Updated October 2025. ASCCP. October 2025. Accessed March 20, 2026. https://www.asccp.org/wp-content/uploads/2025/11/ASCCP-Practice-Advisory-Self-Collection-for-Cervical-Cancer-Screening-final-updated-10-2-25.pdf