HPV DNA testing and self-sampling
A swab tested for the virus that causes cervical cancer, more accurate than the Pap smear and doable at home.
HPV primary screening detects CIN3+ more sensitively than cytology and allows 5-year intervals; it is the WHO-recommended screening test and is standard in the Netherlands, Australia, England, and increasingly the US. Self-collected vaginal samples perform as well as clinician samples for PCR-based tests; the FDA approved self-collection in health-care settings in May 2024 and the first at-home kit in 2025. Extended genotyping and methylation triage (FAM19A4/miR124-2) reduce colposcopy referrals. Point-of-care and AI-read tests target low-resource settings.
How it works
Nucleic acid amplification or hybrid capture of high-risk HPV types (16, 18 and 12 others) from cervical or vaginal cells.
- Higher sensitivity for precancer than cytology
- Self-sampling reaches never-screened women
- Long safe intervals cut cost
- Lower specificity in young women (transient infection)
- Needs triage (cytology, genotyping, methylation) before colposcopy
School-based vaccination at 12-13 with high uptake nearly abolishes cervical cancer in vaccinated cohorts, even with a vaccine covering only two HPV types. Screening intervals and the future of cervical screening can now be redesigned around vaccination status.
Vaccinating girls before they are exposed to HPV prevents most cervical cancers. Catch-up vaccination in young adults still helps, but less. Combined with HPV screening, elimination of cervical cancer as a public health problem is a realistic goal.
Women can collect their own screening sample at home with no loss of accuracy if the laboratory uses a PCR test. Sending kits directly is the most effective way to reach women who do not attend, which matters because most cervical cancers occur in under-screened women.
Latest papers
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