This Simple Test Could Replace the Dreaded Pap Smear

Yahoo

13-05-2025

Let's be honest: Pap smears are terrible. Every year, I stare at the ceiling and try my hardest to ignore the scraping of my insides. In the age of AI chatbots and self-driving cars, how has no one figured out a less torturous way to screen for cervical cancer?Well, there is, but chances are you haven't heard about it. 🩺SIGN UP for tips to stay healthy & fit with the top moves, clean eats, health trends & more delivered right to your inbox twice a week💊Back in 2024, the U.S. government approved an HPV self-collection test for the detection of two cancer-causing types of HPV in the cervix. Instead of a pelvic exam, women can gently swab a vaginal sample, which the doctors can use in their cervical cancer screening.Yet despite the FDA approval, most medical offices have been slow in rolling out self-collection tests for patients. That means if you're interested in the Pap smear alternative, you have to personally request it from your doctor. So before you head to your next gyno appointment, learn more about this pain-free alternative to cervical cancer screenings. Related:
There are currently two FDA-approved self-collection tests in the U.S. The first is Onclarity HPV, made by Becton, Dickinson and Company (BD), and Cobas HPV, made by Roche Molecular Systems. Both tests are successful in detecting 14 cancer-causing HPV types, and types 16 and 18.Related:
OB/GYN , works with BD, one of the makers of the two FDA-approved self-collection tests. While it detects for possible cervical cancer like a Pap smear, it does so differently, she tells Parade. A Pap smear takes a spatula and scrapes the cervix for samples. These samples are then placed on a microscope slide and observed for abnormal cells. HPV tests use DNA samples for certain strains. Almost all cervical cancer cases come from long-lasting HPV infection in high-risk strains."The way it's currently reported in labs in the US is you either have high risk or low risk. We don't call out all the different strains of HPV, some of which are more likely to cause cervical cancer than others," Dr. Prabakar explains. "We're not getting into the nitty gritty of what strain a person has, and we're meeting women with a lot of confusion and a lot of questions about the type of HPV they have."
The HPV self-collection test uses a swab about the size of a small tampon. You open the tube and insert the swab into your vagina, where you swirl it around for 20 seconds. Afterward, you close the tube and give it to your doctor, who will send it to the lab for testing.Dr. Prabakar's patients have reported self-collection testing to be easy and pain-free. One appeal is that they can control the depth of the swab insertion, avoiding the usual discomfort you would feel from a pap smear. She says this is an appealing alternative for people who have skipped out on going to the doctor because of the pain of Pap smears, especially if they have a history of trauma.
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Currently, no. Both of the two FDA-approved self-collection tests require vaginal sampling to happen in a health care setting such as a doctor's office, urgent care, pharmacies and mobile clinics. "In my practice, I leave the room and they do it in the bathroom or the exam room. It takes 20 seconds," Dr. Prabakar says.Related:
Research has found self-swabbing is as accurate, if not more, than when a doctor takes a sample. In one study that had each participant swabbed twice, one by themselves and the other by a doctor, higher HPV rates were found in the self-collection samples. A review of the FDA-approved self-swab tests found that the Cobas HPV test by Roche had false negatives in 8.7% of the tested samples. Additionally, there is limited data on how the test works on women who have received the HPV vaccine. The Onclarity HPV test by BD showed differences in detecting the disease between vaccinated and unvaccinated women. The review also found a small risk of false negatives when vaginal creams are present during swabbing. According to the authors, it is unknown how vaginal discharge, tampon use and douching affect the results for both FDA-approved tests.
Dr. Prabakar says there were initial concerns that someone could lie about their sample and swab an unrelated object like a countertop. However, the test has an internal control, usually human β-globin in DNA, where if labs don't detect enough of it, they can tell it is not a good-quality sample."It's foolproof," Dr. Prabakar adds. "Out of all the patients that have done it in my office, I've never had an unsatisfactory one where they had to repeat it."HPV screens are an accepted and validated method of cervical cancer screening. That being said, the only drawback is that it will not completely replace the Pap smear. Dr. Prabakar says if the self-swab comes up positive, people will need to follow up with a Pap smear. "You're not completely eliminating the Pap, but it's pretty close to it," she explains. "For the few who end up having a positive HPV test, then we need to do the Pap to get some cells and see what's going on there."Related:
Most women do not need an annual Pap smear. The guidelines for cervical cancer screenings have shifted for women between 21 and 29 to have Pap smears every three years. Women between 30 and 65 should undergo an HPV test every five years."Screening is not done every year, so it is every three to five years, which a lot of women do not know," says Dr. Prabakar. "We used to send postcards like 'hey, it's time for your annual Pap smear,' but these guidelines have changed."Related:
A major benefit of an HPV self-collection test is that it's covered by insurance. "All of my patients have been able to have it covered, just as they would have with the Pap. It's not been a problem," says Dr. Prabakar. If you do not have insurance, the test is inexpensive, costing less than a hundred dollars.
You may have heard that cervical cancer isn't as deadly as it used to be, and it's true: Thanks to expanded cancer screenings in the mid-1970s, cervical cancer is detected much earlier than it used to be. However, Dr. Prabakar says cervical cancer is still a concerning problem if women avoid getting screened. "A woman dies every 90 seconds from cervical cancer," says Dr. Parbakar. "This is still a prevalent type of cancer throughout the world, and screening does not happen everywhere." Newer alternatives to cervical cancer screenings, like self-collection tests, are what Dr. Parbakar considers a "game-changer" because they're quick and gentle. Additionally, she says that knowing the type of HPV strain a person has may eliminate a lot of invasive procedures. "Cervical cancer is one of those cancers that can be prevented and hopefully eradicated in our lifetime, which is exciting," she concludes.
Up Next:FDA Approves HPV Tests That Allow for Self-Collection in a Health Care Setting. National Cancer Institute.
HPV-Associated Cancers and Precancers. Centers for Disease Control and Prevention.
BD Onclarity™ HPV Assay. BD.
cobas® HPV Test. Roche Diagnostics.
Dr. Cheruba Prabakar, MD, FACOG, is an OB/GYN affiliated with Becton, Dickinson and company (BD).
Evaluation of Pre-Analytical Variables for Human Papillomavirus Primary Screening from Self-Collected Vaginal Swabs. The Journal of Molecular Diagnostics.
Performance of a vaginal self-collection device versus clinician collected cervical samples for the detection of high-risk human papillomavirus. Preventive Medicine Reports.
A review of the FDA-approved molecular testing platforms for human papillomavirus. Journal of the American Society of Cytopathology.
Cervical Cancer: Screening. U.S. Preventive Services Task Force.
Key Statistics for Cervical Cancer. American Cancer Society.