Genital human papillomavirus is the most common sexually transmitted infection in the United States and is thought to be responsible for more than 99% of cervical cancers.
HPV screening usually entails a speculum-based exam, which is an uncomfortable experience for most patients, especially those who have physical disabilities.
In two studies, published in Preventive Medicine Reports and JAMA Network Open, University of Michigan researchers are the first to demonstrate in the U.S. that self-sampling is just as effective as speculum-based testing for HPV detection.
Most people who have HPV are usually unaware that they have it.
By age 50, at least 4 out of 5 women will have been infected with the virus at some point in their lives.
Usually, these infections disappear within 2 years, due to the body’s defenses. However, in some women the infection lingers and puts them at risk for cervical cancer.
Currently, cervical cancer screens and HPV testing is recommended for women every 3 to 5 years starting at age 25.
“Co-testing for HPV and cervical cancer is not useful in any meaningful way. You can find the same occurrence of cervical cancer and its precursors by just testing for HPV alone,” said Diane Harper, M.D., a professor of obstetrics and gynecology, family medicine and women’s and gender studies and senior author of both studies.
Additionally, the entire process can be physically and emotionally taxing.
“Half of the women in the U.S. who have cervical cancer did not undergo a screening test in the past ten years. We should try to make it a more comfortable experience,” Harper said.
Several countries, including Sweden, Australia and the Netherlands, that have adopted self-screening for HPV have also reduced their incidence for cervical cancer.
“We wanted to focus on the U.S. population and compare self-sampling to speculum-based HPV testing,” Harper said.
Vaginal swabs are useful for first-line HPV screening
The researchers used a cohort of 193 people, between 25 and 65 years, who were either undergoing a routine screening or were at risk for cervical cancer.
“Half of the women in the US who have cervical cancer did not undergo a screening test in the past ten years. We should try to make it a more comfortable experience.” – Diane Harper, M.D.The study participants were instructed to use vaginal swabs, which were then collected and sent to the laboratory. They also underwent speculum exams.
All the samples were tested for 15 types of high risk HPV types.
“We found that using swabs is equivalent to speculum-based collection,” Harper said.
The team also found that their results were in agreement with global data on HPV prevalence, reinforcing the usefulness of vaginal swabs.
Self-sampling improves screening experiences for those with physical disabilities
“Women with physical disabilities have lower rates of cervical cancer screening due to several barriers, including inaccessible healthcare facilities, healthcare providers misunderstanding their risk for cervical cancer and difficulty with positioning for a speculum exam,” said Susan Ernst, M.D., a clinical associate professor of obstetrics and gynecology and an author of one of the studies.
Using a cohort of 56 women who had physical disabilities, the researchers tested whether they also preferred vaginal swabs over speculums.
“I was already aware that speculum-based exams can sometimes be unpleasant. However, some of the experiences the participants shared with us were truly horrifying,” said Corrianne Norrid, a medical student at U-M Medical school and co-first author of the study.
The women described in-office speculum-based screenings as “cold”, “traumatizing” and “invasive”. However, when asked about the at-home self-sampling, the women described the experience as “simple”, “comfortable”, and “feasible”.
“The swabs cannot replace having a conversation with your doctor. However, it can save the vast majority of women from getting unnecessary speculum tests,” Harper said.
The researchers are working with U-M Health to make self-sampling the primary method for cervical cancer screening in their clinics.
The researchers hope that results from both studies will inform education and promotion efforts to all people.
“This is a great example of how multiple disciplines at Michigan Medicine work together,” Harper said.
“Our next goal is to find a cure for HPV.”Reference:Alisa P. Young, Mutiya Olorunfemi, Leigh Morrison, Scott A. Kelley, Anna Laurie, Anna McEvoy, Jill Schneiderhan, Julie Prussack, Marie Claire O’Dwyer, Pamela Rockwell, Philip Zazove, Jonathan Gabison, Jane Chargot, Kristina Gallagher, Ananda Sen, Dongru Chen, Elizabeth A. Haro, Emma A. Butcher, Martha L. Alves, Christelle El Khoury, Melinda L. Dendrinos, Nicole Brashear, Roger Smith, Richard W. Lieberman, Natalie Saunders, Elizabeth Campbell, Heather M. Walline, Diane M. Harper, Cervical cancer screening: Impact of collection technique on human papillomavirus detection and genotyping, Preventive Medicine Reports, https://doi.org/10.1016/j.pmedr.2025.102971. read more

China: A recent study published in the International Journal of Women’s Health has shed light on the potential causal relationship between sarcopenia and gestational diabetes mellitus (GDM), revealing significant insights that could influence future clinical management and intervention strategies. The study found that sarcopenia raises the risk of gestational diabetes mellitus.”Key indicators of sarcopenia, such as appendicular lean mass (HR = 1.22), grip strength (HR = 1.42 for the right hand, HR = 1.61 for the left hand), and walking pace (HR = 3.37), were associated with an increased risk of developing GDM. However, GDM did not appear to have any impact on sarcopenia, highlighting sarcopenia as a potential risk factor for the condition,” the researchers reported. Sarcopenia, often associated with aging, is increasingly recognized as a condition that can affect a wide range of individuals, including pregnant women. The condition is characterized by a decline in muscle function, leading to reduced mobility, increased frailty, and a greater risk of metabolic disorders. On the other hand, GDM is a type of diabetes that develops during pregnancy and is associated with various health risks for both the mother and the baby, including preeclampsia, premature birth, and a higher likelihood of developing type 2 diabetes later in life.Against the above background, Dongyu Wang, Guangdong Provincial Clinical Research Center for Obstetrical and Gynecological Diseases, Guangzhou, People’s Republic of China, and colleagues employed a bi-directional Mendelian randomization (MR) approach to investigate this complex relationship. For this purpose, the researchers used data from FinnGen datasets and genome-wide association studies. They conducted a bi-directional MR study, starting with a forward MR analysis to assess the causal effect of sarcopenia on GDM risk, with sarcopenia-related traits as exposures and GDM as the outcome. In the reverse MR analysis, they evaluated whether GDM influenced sarcopenia-related traits. Finally, a sensitivity analysis was performed to test the robustness of the MR findings. The study revealed the following findings:Forward MR analysis found that appendicular lean mass was associated with an increased risk of GDM (OR = 1.2182).Right-hand grip strength was linked to a higher risk of GDM (OR = 1.4194).Left-hand grip strength showed a significant association with increased GDM risk (OR = 1.6064).Usual walking pace was also associated with a higher risk of GDM (OR = 3.3676).Reverse MR results indicated that GDM had no causal effect on sarcopenia.There was no pleiotropy in the analysis.”Our study provides further evidence that sarcopenia contributes to the development of gestational diabetes mellitus (GDM), while GDM does not have a causal effect on sarcopenia. This insight paves the way for targeted interventions and personalized care to help reduce the risk of GDM in pregnant individuals,” the researchers wrote. “Additional research is needed to better understand the complex physiological pathways involved and to develop effective prevention and management strategies,” they concluded.Reference:Huang, Y., Zhao, S., Hong, J., Shen, L., Wang, Z., & Wang, D. (2025). Causal Associations Between Sarcopenia and Gestational Diabetes Mellitus. International Journal of Women’s Health, 17, 259–269. https://doi.org/10.2147/IJWH.S494910 read more

According to a Canadian retrospective cohort study the use of probiotics in neonatal units was associated with decreased mortality in preterm and low-birth-weight infants. However Probiotic use did not significantly impact rates of necrotizing enterocolitis (NEC) or late-onset sepsis. Despite no change in NEC or sepsis rates, overall mortality was lower in infants who received probiotics. Results derived from information on more than 32,000 preterm infants, underscore the potential advantages and hazards of NICU use of probiotics. Pharmaceutical-grade probiotic access concerns, doubts about efficacy, and the possibility of probiotic sepsis have curative adoption on a large scale. The study was published in the journal Pediatrics.The study reviewed data from 32,667 preterm babies, born under 34 weeks of gestational age; all were admitted in 33 NICUs across Canada between January 2016 and December 2022. Excluded from the analysis at admission were moribund infants, those who succumbed to death in the first two days, those admitted beyond two days after birth, those with severe congenital anomalies, and those for whom enteral feeds were never initiated.Among the infants who were included, 57.5% were administered probiotics with a median gestational age of 29 weeks, whereas 42.5% were not, and the median gestational age was 31 weeks. The researchers performed adjusted analyses to assess the relationship between the use of probiotics and clinical outcomes such as mortality, NEC, late-onset sepsis, and probiotic sepsis.Key FindingsProbiotic treatment was linked to a 38% decrease in mortality in all infants born prior to 34 weeks’ gestation (adjusted odds ratio [aOR] 0.62, 98.3% confidence interval [CI] 0.53-0.73).In infants with birth weight <1,000 g, probiotic treatment was associated with a 42% decrease in mortality (aOR 0.58, 98.3% CI 0.47-0.71).There was no significant decrease found in the incidence of NEC in all preterm infants (aOR 0.92, 98.3% CI 0.78-1.09) or birth weight <1,000 g (aOR 0.90, 98.3% CI 0.71-1.13).No reduction in late-onset sepsis was found among preterm infants (aOR 0.90, 98.3% CI 0.80-1.01) or birth weight <1,000 g (aOR 1.01, 98.3% CI 0.86-1.18).Probiotic sepsis was uncommon, occurring in 27 infants born at <34 weeks’ gestation and 20 infants with a birth weight of <1,000 g. Three infants with probiotic sepsis died, and the condition was considered a potential cause in two.The study authors concluded that probiotics can significantly decrease mortality in preterm and low-birth-weight neonates but do not lower the rate of NEC or late-onset sepsis considerably. The result emphasizes the role of probiotics in neonatal management while being mindful of the necessity for ongoing caution about probiotic-related risk, especially probiotic sepsis. More research is needed to make probiotics more precise in NICU practice and provide definite guidelines for their efficient and safe application.Reference:Alshaikh, B. N., Ting, J., Lee, S., Lemyre, B., Wong, J., Afifi, J., Beltempo, M., & Shah, P. S. (2025). Effectiveness and risks of probiotics in preterm infants. Pediatrics, 155(3). https://doi.org/10.1542/peds.2024-069102 read more