At-Home Integrated HPV Self-Collection With Telehealth
DOI:
https://doi.org/10.30953/thmt.v11.729Keywords:
Cervical cancer, HPV, integrated telehealth, screening, self-collectionAbstract
Objective: At—home papillomavirus (HPV) self-collection (SC) can overcome screening barriers and expand access. We analyzed data from the first FDA-authorized at-home HPV SC with integrated telehealth offering. papillomavirus (HPV) self-collection (SC).
Methods: Descriptive analysis of routine data, including medical records, satisfaction surveys, user feedback, and back-end data from the telehealth system. Participants met screening guidelines (25- to 65-year-old intact cervix) but were ineligible due to pregnancy, a history of high-grade squamous intraepithelial lesion, a loop electrosurgical excision procedure, immunosuppression, or abnormal bleeding. Analysis focused on HPV test results by April 16, 2026. A digital intake, a telehealth visit, SC at home, and digital results delivery were completed. Those with HPV-positive results had a follow-up telehealth visit with navigation to in-person triage. Descriptive statistics examined participants’ demographic characteristics, prior screening history, reasons for choosing at-home screening, and satisfaction.
Results: During the first ten months following introduction, at-home SC provided 2,881 users with cervical cancer screening results.
- SC users represented all 50 states, 16% rural.
- >12% had never screened previously, 59% ≥ 5 years from screening.
Reasons for SC included privacy/convenience (50%), distrust/avoidance of in-person care (17%), pain with exams/vaginismus (11%), work/childcare obligations (9%), and trauma (7%).
High levels of satisfaction, including ease of use (97%), the telehealth new patient visit (97%), comfort (94%), and overall experience (99%).
Conclusions: At-home SC increased participation in screening, particularly for never/under-screened and overcame barriers. Telehealth-enabled screening modalities reach women who do not access or prefer clinic-based screening, including rural dwellers, mitigating disparities in cervical screening in the U.S.
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References
1. National Cancer Institute (SEER Program). Cancer Stat Facts: Cervical Cancer [Internet]. Bethesda (MD): National Cancer Institute; [cited 2025 Jul 30]. Available from: https://seer.cancer.gov/statfacts/html/cervix.html
2. National Cancer Institute. Cervical Cancer Screening (PDQ) – Patient Version [Internet]. Bethesda (MD): National Cancer Institute; 2022 [cited 2026 Mar 9]. Available from: https://www.cancer.gov/types/cervical/screening
3. U.S. Preventive Services Task Force, Curry SJ, Krist AH, Owens DK, Barry MJ, Caughey AB, et al. Screening for Cervical Cancer: U.S. Preventive Services Task Force Recommendation Statement. JAMA. 2018 Aug 21;320(7):674-86. doi:10.1001/jama.2018.10897
4. Amboree TL, Damgacioglu H, Sonawane K, Adsul P, Montealegre JR, Deshmukh AA. Recent trends in cervical cancer incidence, stage at diagnosis, and mortality according to county-level income in the United States, 2000–2019. Int J Cancer. 2024;154(9):1549–55. doi:10.1002/ijc.34860
5. Siegel RL, Kratzer TB, Giaquinto AN, Sung H, Jemal A. Cancer statistics, 2025. CA Cancer J Clin. 2025;75(1):10–45. doi:10.3322/caac.21871 PubMed PMID: 39817679; PubMed Central PMCID: PMC11745215.
6. Bilalaga MM, Gaddipati G, Devkota A, Vasireddy R, Akhiwu T, Atarere J, et al. HPV knowledge and non-adherence to cervical cancer screening before and following the COVID-19 pandemic in the United States. PLOS Glob Public Health. 2025 Sep 10;5(9):e0004800. doi:10.1371/journal.pgph.0004800
7. Bandi P, Star J, Mazzitelli N, Nargis N, Islami F, Siegel RL, et al. Prevalence and Review of Major Modifiable Cancer Risk Factors, HPV Vaccination, and Cancer Screenings in the United States: 2025 Update. Cancer Epidemiol Biomarkers Prev. 2025 Jun 3;34(6):836–49. doi:10.1158/1055-9965.EPI-24-1835
8. Suk R, Hong YR, Rajan SS, Xie Z, Zhu Y, Spencer JC. Assessment of U.S. Preventive Services Task Force Guideline–Concordant Cervical Cancer Screening Rates and Reasons for Underscreening by Age, Race and Ethnicity, Sexual Orientation, Rurality, and Insurance, 2005 to 2019. JAMA Netw Open. 2022 Jan 18;5(1):e2143582. doi:10.1001/jamanetworkopen.2021.43582
9. Fuzzell LN, Perkins RB, Christy SM, Lake PW, Vadaparampil ST. Cervical cancer screening in the United States: Challenges and potential solutions for under-screened groups. Prev Med. 2021 Mar 1:106400. doi:10.1016/j.ypmed.2020.106400
10. Shpendi S, Norman P, Gibson-Miller J, Webster R. Identifying the key barriers, facilitators and factors associated with cervical cancer screening attendance in young women: A systematic review. Womens Health. 2025 Mar 13;21:17455057251324309. doi:10.1177/17455057251324309 PubMed PMID: 40080394; PubMed Central PMCID: PMC11907612.
11. Farajimakin O. Barriers to Cervical Cancer Screening: A Systematic Review. Cureus. 2026 Feb [Epub ahead of print]. 16(7):e65555. doi:10.7759/cureus.65555 PubMed PMID: 39192892; PubMed Central PMCID: PMC11347962.
12. Soltani LF, Addis I, Lin P, Kamdar N, O’Dwyer MC, Young AP, et al. Characterizing Cervical Cancer Screening in the us: Preparing for the Era of Self-Collection. J Am Board Fam Med. 2026 Feb 16. doi:10.3122/jabfm.2025.250040R1 PubMed PMID: 41698781.
13. Boitano TKL, Powell MA, Leath CA, Michael Straughn J, Scarinci IC. Barriers and facilitators affecting presentation in women with early versus advanced stage cervical cancer. Gynecol Oncol Rep. 2022 Apr 1;40:100950. doi:10.1016/j.gore.2022.100950
14. Fontham ETH, Wolf AMD, Church TR, Etzioni R, Flowers CR, Herzig A, et al. Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society. CA Cancer J Clin. 2020;70(5):321–46. doi:10.3322/caac.21628
15. Shin MB, Axeen S, Cole AM, Guo XM, Islam JY, Ko LK, et al. Nonadherence to Cervical Cancer Screening Guidelines in Commercially Insured U.S. Adults, 2013-2021. JAMA Netw Open. 2025 Dec 10;8(12):e2548512. doi:10.1001/jamanetworkopen.2025.48512
16. Perkins RB, Wolf AMD, Church TR, Elkin EB, Skates SJ, Etzioni RD, et al. Self-collected vaginal specimens for human papillomavirus testing and guidance on screening exit: An update to the American Cancer Society cervical cancer screening guideline. CA Cancer J Clin. 2026;76(1):e70041. doi:10.3322/caac.70041
17. Health Resources and Services Administration (U.S.). Women’s Preventive Services Guidelines [Internet]. Rockville (MD): HRSA; [cited 2026 Mar 9]. Available from: https://www.hrsa.gov/womens-guidelines
18. U.S. Preventive Services Task Force. Draft Recommendation: Cervical Cancer: Screening [Internet]. Rockville (MD): usPSTF; [cited 2025 Dec 23]. Available from: https://www.uspreventiveservicestaskforce.org/uspstf/draft-recommendation/cervical-cancer-screening-adults-adolescents#fullrecommendationstart
19. American Cancer Society. HPV Self-Collection Test [Internet]. Atlanta (GA): American Cancer Society; 2025 [cited 2026 Mar 9]. In-clinic and At-home HPV Self-collection Test. Available from: https://www.cancer.org/cancer/risk-prevention/hpv/hpv-and-hpv-testing/self-collection.html
20. Teal Health. Teal Health Expands Nationwide, Bringing the Only FDA-Authorized Device for At-Home Cervical Cancer Screening to All 50 States [Internet]. New York: PR Newswire; [cited 2026 Mar 9]. Available from: https://www.prnewswire.com/news-releases/teal-health-expands-nationwide-bringing-the-only-fda-authorized-device-for-at-home-cervical-cancer-screening-to-all-50-states-302654685.html
21. Health Resources and Services Administration (us). New Cervical Cancer Screening Guidelines Strengthen Women’s Preventive Health [Internet]. Rockville (MD): HRSA; [cited 2026 Mar 9]. Available from: https://www.hrsa.gov/about/news/press-releases/new-cervical-cancer-screening-guidelines
22. Andersson H, Dillner J. Population-based cervical screening with Human Papillomavirus self-sampling at home and incidence of cervical cancer in Sweden. Prev Med. 2026 May 1;206:108540. doi:10.1016/j.ypmed.2026.108540
23. Pretsch PK, Spees LP, Brewer NT, Hudgens MG, Sanusi B, Rohner E, et al. Effect of HPV self-collection kits on cervical cancer screening uptake among under-screened women from low-income U.S. backgrounds (MBMT-3): a phase 3, open-label, randomised controlled trial. Lancet Public Health. 2023 Jun;8(6):e411–21. doi:10.1016/S2468-2667(23)00076-2 PubMed PMID: 37182529; PubMed Central PMCID: PMC10283467.
24. Montealegre JR, Hilsenbeck SG, Bulsara S, Parker SL, Amboree TL, Anderson ML, et al. Self-Collection for Cervical Cancer Screening in a Safety-Net Setting. JAMA Intern Med. 2025 Jun 6;e252971. doi:10.1001/jamainternmed.2025.2971 PubMed PMID: 40478588; PubMed Central PMCID: PMC12144659.
25. Swenson E, VonderHaar E, Ruiz J, Segalova P, Su V, Mouton C, Lee H, Santos L, Mukherjee M. Delivering HPV results via telehealth: Patient needs and engagement following an at-home self-collection study. Digit Health. 2026 Feb 10;12:20552076261421347. doi: 10.1177/20552076261421347. PMID: 41685227; PMCID: PMC12891408.
26. Fitzpatrick MB, Behrens CM, Hibler K, Parsons C, Kaplan C, Orso R, et al. Clinical Validation of a Vaginal Cervical Cancer Screening Self-Collection Method for At-Home use: A Nonrandomized Clinical Trial. JAMA Netw Open. 2025 May 19;8(5):e2511081. doi:10.1001/jamanetworkopen.2025.11081
27. F. Hoffmann-La Roche Ltd. Roche announces FDA approval of one of the first HPV self-collection solutions in the us, expanding access and screening options to help eliminate cervical cancer [Internet]. Basel: Roche; 2024 May 15 [cited 2026 Mar 9]. Available from: https:/www.roche.com/media/releases/med-cor-2024-05-15
28. Perkins RB, Guido RL, Saraiya M, Sawaya GF, Wentzensen N, Schiffman M, et al. Summary of Current Guidelines for Cervical Cancer Screening and Management of Abnormal Test Results: 2016–2020. J Womens Health. 2021 Jan 1;30(1):5–13. doi:10.1089/jwh.2020.8918 PubMed PMID: 33464997; PubMed Central PMCID: PMC8020523.
29. us Census Bureau. American Community Survey (ACS) [Internet]. Suitland (MD): U.S. Census Bureau; [cited 2026 Mar 9]. Available from: https://www.census.gov/programs-surveys/acs.html
30. us Census Bureau. Areas With Concentrated Poverty: 2006-2010 [Internet]. Suitland (MD): U.S. Census Bureau; 2011 [cited 2026 May 19]. Available from: https://www.census.gov/library/publications/2011/acs/acsbr10-17.html
31. Krieger N, Chen JT, Waterman PD, Soobader MJ, Subramanian SV, Carson R. Geocoding and monitoring of U.S. socioeconomic inequalities in mortality and cancer incidence: does the choice of area-based measure and geographic level matter?: the Public Health Disparities Geocoding Project. Am J Epidemiol. 2002 Sep 1;156(5):471–82. doi:10.1093/aje/kwf068 PubMed PMID: 12196317.
32. Health Resources and Services Administration (us). Federal Office of Rural Health Policy [Internet]. Rockville (MD): HRSA; [cited 2026 Apr 1]. Available from: https://www.hrsa.gov/about/organization/bureaus/forhp
33. Perkins RB, Guido RS, Castle PE, Chelmow D, Einstein MH, Garcia F, et al. 2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors. J Low Genit Tract Dis. 2020 Apr;24(2):102–31. doi:10.1097/LGT.0000000000000525 PubMed PMID: 32243307; PubMed Central PMCID: PMC7147428.
34. Arbyn M, Smith SB, Temin S, Sultana F, Castle P, Collaboration on Self-Sampling and HPV Testing. Detecting cervical precancer and reaching underscreened women by using HPV testing on self samples: updated meta-analyses. BMJ. 2018 Dec 5;363:k4823. doi:10.1136/bmj.k4823 PubMed PMID: 30518635; PubMed Central PMCID: PMC6278587.
35. Costa S, Verberckmoes B, Castle PE, Arbyn M. Offering HPV self-sampling kits: an updated meta-analysis of the effectiveness of strategies to increase participation in cervical cancer screening. Br J Cancer. 2023 Mar;128(5):805–13. doi:10.1038/s41416-022-02094-w PubMed PMID: 36517552; PubMed Central PMCID: PMC9977737.
36. Lee A, Hawkes D, Sweeney D, Wyatt K, Nightingale C, Chalmers C, et al. Exponential uptake of HPV self-collected cervical screening testing 2 years since universal availability in Victoria, Australia. BMC Med. 2025 Jul 1;23:389. doi:10.1186/s12916-025-04219-3 PubMed PMID: 40598474; PubMed Central PMCID: PMC12220328.
37. Green BB, Moqk J, Crawford-Gallagher B, Beatty TC, Gao H, Piccorelli AV, et al. Impact of a Clinic- and Mail-Based Cervical Cancer Human Papillomavirus Self-Collect Screening Program. NEJM Cata. 2026 May 20; 7(6). doi: 10.1056/CAT.25.0420.
38. Nelson EJ, Maynard BR, Loux T, Fatla J, Gordon R, Arnold LD. The acceptability of self-sampled screening for HPV DNA: a systematic review and meta-analysis. Sex Transm Infect. 2017 Feb;93(1):56–61. doi:10.1136/sextrans-2016-052609 PubMed PMID: 28100761.
39. MacKinnon KM, Risica PM, von Ash T, Scharf AL, Lamy EC. Barriers and motivators to women’s cancer screening: A qualitative study of a sample of diverse women. Cancer. 2023 Sep;129(S19):3152–61. doi:10.1002/cncr.34653 PubMed PMID: 37691528.
40. Camara H, Zhang Y, Lafferty L, Vallely AJ, Guy R, Kelly-Hanku A. Self-collection for HPV-based cervical screening: a qualitative evidence meta-synthesis. BMC Public Health. 2021 Aug 4;21(1):1503. doi:10.1186/s12889-021-11554-6
41. Nishimura H, Yeh PT, Oguntade H, Kennedy CE, Narasimhan M. HPV self-sampling for cervical cancer screening: a systematic review of values and preferences. BMJ Glob Health. 2021 May;6(5):e003743. doi:10.1136/bmjgh-2020-003743 PubMed PMID: 34011537; PubMed Central PMCID: PMC8137189.
42. Petersen Z, Jaca A, Ginindza TG, Maseko G, Takatshana S, Ndlovu P, et al. Barriers to uptake of cervical cancer screening services in low-and-middle-income countries: a systematic review. BMC Womens Health. 2022 Dec 2;22(1):486. doi:10.1186/s12905-022-02043-y PubMed PMID: 36461001; PubMed Central PMCID: PMC9716693.
43. Le A, Rohweder C, Wheeler SB, Lafata JE, Teal R, Giannone K, Zaffino M, Smith JS. Self-Collection for Primary HPV Testing: Perspectives on Implementation From Federally Qualified Health Centers. Prev Chronic Dis. 2023 Oct 19;20:E93. doi: 10.5888/pcd20.230056. PMID: 37857461; PMCID: PMC10599328.
44. Winer RL, Lin J, Anderson ML, Tiro JA, Green BB, Gao H, et al. Strategies to Increase Cervical Cancer Screening With Mailed Human Papillomavirus Self-Sampling Kits: A Randomized Clinical Trial. JAMA. 2023 Nov 28;330(20):1971–81. doi:10.1001/jama.2023.21471 PubMed PMID: 38015219; PubMed Central PMCID: PMC10685881.
45. American Cancer Society. Cervical Cancer Screening Guidelines [Internet]. Atlanta (GA): American Cancer Society; [cited 2026 Mar 9]. Available from: https://www.cancer.org/health-care-professionals/american-cancer-society-prevention-early-detection-guidelines/cervical-cancer-screening-guidelines.html
46. Spencer JC, Montealegre JR, Calderón-Mora J, Pignone MP. Breast, Cervical, and Colorectal Cancer Screening Rates in Women Aged 45 to 64 Years. JAMA Netw Open. 2026 May 1;9(5):e2612976. doi:10.1001/jamanetworkopen.2026.12976 PubMed PMID: 42138919; PubMed Central PMCID: PMC13179544.
47. Ye Z, Wang H, Zhong Y, Wang J, Jin S, Wu B, et al. High-risk HPV distribution and importance of continuing cervical cancer screening of women aged 65 years and older: a study based on 2 152 766 women in China. Gynecol Obstet Clin Med. 2025 Jul 1;5(2). doi:10.1136/gocm-2025-000238.
48. Hermansson RS, Olovsson M, Gustavsson C, Lindström AK. Elderly women’s experiences of self-sampling for HPV testing. BMC Cancer. 2020 May 26;20:473. doi:10.1186/s12885-020-06977-0 PubMed PMID: 32456679; PubMed Central PMCID: PMC7249375.
49. Fitch K, Bohn JA, Emerson JB, Boniface ER, Bruegl A. Acceptability of human papillomavirus self-collection and the role of telehealth: a prospective, randomized study stratified by menopausal status. Int J Gynecol Cancer. 2024 Jan 1;34(1):19–27. doi:10.1136/ijgc-2023-004935
50. Beavis AL, Gravitt PE, Rositch AF. Hysterectomy-corrected cervical cancer mortality rates reveal a larger racial disparity in the United States. Cancer. 2017 May 15;123(6):1044–50. doi:10.1002/cncr.30507 PubMed PMID: 28112816.
51. Amboree TL, Damgacioglu H, Chiao EY, Schmeler KM, Sonawane K, Deshmukh AA, et al. Rural-Urban Disparities in Cervical Cancer Incidence and Mortality Among U.S. Women. JAMA Netw Open. 2025 Mar 3;8(3):e2462634. doi:10.1001/jamanetworkopen.2024.62634
52. Shaver J. The State of Telehealth Before and After the COVID-19 Pandemic. Prim Care. 2022 Dec;49(4):517–30. doi:10.1016/j.pop.2022.04.002 PubMed PMID: 36357058; PubMed Central PMCID: PMC9035352.
53. Weiner JP, Bandeian S, Hatef E, Lans D, Liu A, Lemke KW. In-Person and Telehealth Ambulatory Contacts and Costs in a Large U.S. Insured Cohort Before and During the COVID-19 Pandemic. JAMA Netw Open. 2021 Mar 23;4(3):e212618. doi:10.1001/jamanetworkopen.2021.2618 PubMed PMID: 33755167; PubMed Central PMCID: PMC7988360.
54. Perkins RB, Adcock R, Benard V, Cuzick J, Waxman A, Howe J, Melkonian S, Gonzales J, Wiggins C, Wheeler CM; New Mexico HPV Pap Registry (NMHPVPR) Steering Committee. Clinical follow-up practices after cervical cancer screening by co-testing: A population-based study of adherence to U.S. guideline recommendations. Prev Med. 2021 Dec;153:106770. doi: 10.1016/j.ypmed.2021.106770. Epub 2021 Aug 18. PMID: 34416221; PMCID: PMC8595756.
55. Cheng D, Rieu-Werden ML, Lykken JM, Werner CL, Feldman S, Silver MI, Atlas SJ, Tiro JA, Haas JS, Kamineni A. Assessing Management of Abnormal Cervical Cancer Screening Results and Concordance with Guideline Recommendations in Three U.S. Healthcare Settings. Cancer Epidemiol Biomarkers Prev. 2024 Jul 1;33(7):912-922. doi: 10.1158/1055-9965.EPI-23-1564. PMID: 38652505; PMCID: PMC11366420.
56. Alakeel AN, Alskait BK, Binshafi GB, AlAmro HA, Alkharji SK, Elsherbini M, et al. The Impact of Telehealth Adoption on Patient Outcomes: A Systematic Review. Cureus. 2025, 17(10):e94328. doi:10.7759/cureus.94328 PubMed PMID: 41220463; PubMed Central PMCID: PMC12598373.
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Copyright (c) 2026 Liz Swenson, MD, FACOG, MSCP, Morgan Mandigo, MD, MSc, FACOG, Elizabeth VonderHaar, MD, FACOG, Vanessa Dorismond, MD, MA, MAS, Jennifer Godbout, MD, FACOG, Anne Dobrzynski, MD, FACOG, Karen McNamara, MSN, FNP-C, Joslin Ruiz, FNP-C, Kiandra Cartwright-Nolting, FNP-C, Meghan Brennan, FNP, Amber Ensley, CNM/PMHNP-BC, Brandi Manning, FNP-C, Trena Depel, MS, Meghna Mukherjee, PhD, Kristen M. Little, PhD MPH
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