Patients at OHSU, which implemented self-collection in its clinics in October 2025, also have reported positive experiences with self-collection, Dr. Lu says, and “adoption is steadily increasing as more clinics become familiar with the process.” Physicians have been supportive as well. “It provides a practical alternative to pelvic exams, particularly for patients who might otherwise defer screening due to fear of the procedure, cultural or religious concerns, gender identity considerations, or time constraints.”
OHSU offers self-collection to all patients eligible for HPV screening. Patients who test positive for HPV16 or 18 are referred for colposcopy. For other high-risk types, cytology or dual-stain triage testing is performed. High-risk patients—those with prior abnormalities, history of CIN2/cervical cancer, or immunocompromising conditions—are directed to clinician-collected testing pathways through a separate order build in the laboratory information system. “This risk-based structure helps guide providers to select the correct test at the time of ordering,” Dr. Lu says.
What advice do Dr. Lu and her colleagues have for those seeking to implement self-collection in the clinic?
“Work with women’s health and primary care leaders to develop institutional guidelines aligned with national specialty recommendations,” Dr. Lu says. “These should incorporate risk-based screening strategies, including primary HPV self-collection for low-risk [patients], HPV and cytology cotesting for high-risk [patients], and appropriate reflex testing pathways.” Physician education is a must, she notes, “particularly ensuring specimens are submitted in the correct media, rather than as dry swabs.”
As self-collection gains purchase in the clinic, when and for whom does at-home collection come into play?
The Teal Wand, at $99 with insurance and $249 without, is not a low-cost cervical cancer screening option. Still, Elizabeth Swenson, MD, Ob-gyn and medical director at Teal Health, is hopeful it can help patients across socioeconomic lines.
The Health Resources and Services Administration announced in January it would reimburse for self-collection and associated follow-up care with no cost-sharing beginning in January 2027. Though it remains to be seen how this will affect patients, Dr. Swenson is cautiously optimistic that the company will be enrolled with more commercial payers as well as Medicaid as patient volumes grow. And in the clinical trial that won the Teal Wand FDA approval, the study population represented a wide range of incomes, she notes.
Then, too, people of means also need better access to cervical cancer screening, she says. There’s the mother with infirm parents and small children who works full time and can’t take a half-day to go to the doctor. There are patients with histories of sexual trauma, or even particularly negative experiences with gynecological care, whose distress prevents them from getting the pelvic exam. “And then, people put it off,” she says, “especially if they get out of their years of childbearing” and assume it’s no longer needed. “I see people every day who haven’t [been] screened in 10, 15, 20 years. This is giving them a chance to get back in,” she says.
The Teal Wand requires a prescription, which the company offers after a brief telehealth consult with a Teal Health physician. Patients may schedule another telehealth appointment after receiving their results, typically available in an online patient portal five days after mailing the sample to the laboratory. Both virtual touchpoints are opportunities for patient education, Dr. Swenson says.
“Our patients come out of even that short 10- to 15-minute visit with more information on HPV and the guidelines and the screenings than they have ever gotten,” she says. Having been a practicing Ob-gyn for over 20 years, she’s sympathetic to the demands placed on physicians, who “have a short window of time to do many, many things” for patients. The telehealth consults have become an opportunity for at-length conversations about cervical cancer screening and the natural history of HPV over the life course. The team tries to be thoughtful in its digital results delivery, too, Dr. Swenson says. All laboratory results arrive with a physician’s note that includes an explanation of the results. “It’s very thoughtful language, and we’ve adjusted and adjusted again.”