The Quick Read
- Roughly 15 million American women have never had a cervical cancer screening—including nearly 1 in 3 women aged 21–29 and 1 in 7 aged 30–65—and screening rates have been declining for two decades.
- Women avoid in-clinic exams due to past medical trauma, long appointment wait times, conditions like vaginismus that make speculums unworkable, care settings that feel non-inclusive, or the false belief that low risk or lack of symptoms eliminates the need to screen.
- First-time screeners report clinic avoidance and past physical or medical trauma as their main drivers for seeking alternative options at nearly double the rate of the general population.
- Teal Health solves these access barriers by offering a painless, FDA-authorized at-home self-collection option that matches in-clinic accuracy and provides complete virtual provider support without requiring a speculum, clinic visit, or existing OB/GYN.
Maybe you've never been to a gynecologist. Maybe you went once, a long time ago, and it didn't go well. Maybe you've simply never found the right moment, the right doctor, or the right reason to make a cervical cancer screening happen.
We learned from women who screened for the first time with Teal Health that there are a range of reasons why a cervical cancer screening did not feel doable to them before. In this blog, we dive deeper into their experiences and how Teal’s at-home self-collection option finally enabled and empowered them.
It's more common than you'd think
A study published last month in JAMA Network Open found that nearly one in three American women between 21 and 29 have never had a cervical cancer screening. That’s about 6.2 million women. Among women 30 to 65, when the risk for cervical cancer is highest, the number is closer to one in seven, or about 9.2 million. Combined, that's roughly 15 million American women who've never been screened, and both figures have been rising for the past two decades.
While the JAMA study clearly outlined that there is a problem with women never going in for their cervical cancer screening, there was little discussion about why – why are so many women avoiding or choosing never to screen in the clinic, with a speculum?
We asked patients who completed their cervical cancer screening for the first time with Teal Health why they had never screened before, to shed light on what’s behind the millions of women across the US putting this screening off. The average age of our patients who have never screened before is 33 years old (ranging from 25-63 years old), well beyond when guidelines recommend routinely screening from age 21, and first-time screeners comprise 7% of all the patients we see.
What we learned, across all the reasons they discussed, is that women need more options for how they can complete their cervical cancer screening in a way that feels comfortable, safe, and is accurate.
Why so many women wait
There's rarely just one reason. A few show up again and again in our data and conversations with our patients.
1. A past negative experience that stuck
For a lot of women, it came down to one exam, sometimes years ago, that was painful, rushed, or handled without much care. Others shared with us an instance of prior physical or sexual trauma that would be triggered during an intimate exam. The memory doesn't fade the way they’d hope. It attaches itself to the idea of any future clinical exam, even with a completely different provider, and it can carry a quiet guilt or pain alongside it.
"I have been traumatized by some doctors before, so the idea of being able to do some screening for myself was like a game changer. It was such a relief." — Patient, 27, Michigan
2. No clear path to a doctor
Plenty of women want to screen and simply haven't found a way in. Many patients who eventually found Teal experienced long waits for a first appointment. A doctor who no longer takes new patients, or their insurance. No established OB/GYN at all, and no obvious place to start looking.
"A lot of doctors are becoming concierge, so you'd get a referral to someone, and then you'd find out they don't see people with your insurance anymore… you'd call and it's like, oh yeah, you can see me in six months. I don't want to wait that long." — Patient, 32, Florida
3. A standard exam that doesn’t fit all bodies
For some women who screened with Teal for the first time, a traditional pelvic exam isn't just uncomfortable; it's genuinely not possible. Conditions like vaginismus can make a speculum exam painful to the point of being unworkable, no matter how ready someone is to go through with it.
"I have a condition called vaginismus… I wasn't able to wear tampons, and I haven't been able to get a Pap smear, because it's also been just so scary." — Patient, 26, California
4. A healthcare system that doesn't feel built for everyone with a cervix
Reproductive care can feel oriented around a fairly narrow kind of patient. Several patients who eventually came to Teal told us that they did not feel the existing healthcare system was designed for them, whether because of their sexual orientation, their gender identity, or simply their life circumstances. It felt like there wasn’t a comfortable or safe way into traditional care.
"I don't love having to meet new providers as a queer person in a reproductive health system that's oriented toward people having children, or having sex with opposite sex partners, which I'm also not doing." — Patient, 38, Colorado
5. A sense that it probably doesn't apply to you
Some Teal patients reasoned their way out of prior screenings: one partner, no symptoms, nothing that feels urgent. Routine cervical cancer screening is critical preventive care for everyone; however, when the standard of care is too painful or feels unfeasible, some women turn to framing themselves as low risk to avoid the in-clinic screening.
"My husband is my only sexual partner in my whole life, and I'm his only sexual partner in his whole life, and I don't smoke, and I've never been pregnant. There's no reason to put yourself through that trauma unless you think there's something wrong." — Patient, 39, North Carolina
It's an understandable instinct, but screening recommendations are based on age and anatomy, not sexual history. HPV can lie dormant for years, sometimes decades, before it's ever detected. That means even one partner, a long time ago, is enough exposure to require routine screening, whether or not anything has ever felt wrong. Guidelines recommend screening for anyone with a cervix in the 21-65 year old age range (and you can begin screening with Primary HPV testing starting at age 25), regardless of sexual history.
6. Or maybe you don't need a reason at all
Not everyone who's never screened is avoiding something. Some women who screened for the first time with Teal simply hadn't come across an option that felt worth trying yet, and hearing about an at-home alternative to the traditional exam was reason enough.
"I'm sort of an adventurous person. When you see something, you're like, hey, I've been looking for this, 27 years." — Patient, 47, New York, on discovering Teal
Not everyone needs a barrier or a bad experience to justify turning to an accurate, FDA-authorized at-home screening. Being curious about a new way of doing something is a perfectly good reason.
What made the difference
The women who've screened with Teal for the first time describe a few things that made the difference, more than any single feature of the product itself: feeling in control to go at their own pace, a provider who took their reasons for waiting seriously, and a process that felt private and predictable.
"I can do it on my own time. If I want to take more time with it, I can, and nobody's forcing me to go faster or do it some way." — Patient, 27, Michigan
In our own data, first-time screeners cite convenience and privacy as their top reasons for choosing Teal. We see these reasons cited among most of our screeners. However, two other reasons show up at a noticeably higher rate (almost double that of our general patient population) among first-time screeners: (1) they are avoiding in-person exams or generally distrust clinics, and (2) they have a history of trauma. While the convenience and privacy of an at-home self-collection opens the door to screening, Teal offers many first-timers a meaningful alternative to the distrust, avoidance, and trauma that kept the door shut for so long.
Why screening matters
Cervical cancer is one of the very few cancers that's almost entirely preventable, but only if it's caught early with routine screening. Almost all cervical cancer is caused by HPV, a common virus that most sexually active people are exposed to at some point. In most cases, it clears on its own. When it doesn't, it can slowly cause changes in cervical cells that may eventually become cervical cancer, which in its earliest (and most treatable) stage does not present with many noticeable symptoms.
Screening doesn't wait for symptoms. It tests for HPV itself, years before it could ever cause a concern. This is why guidelines recommend screening for anyone with a cervix between 25 and 65, including people who've had the HPV vaccine.
Teal is an FDA-authorized self-collection option for at-home cervical cancer screening, built for anyone but especially those who have found the traditional in-clinic path harder than it should be.
The process starts with a short virtual visit with a licensed Teal provider to confirm your eligibility and answer any questions you may have. From there, an at-home self-collection kit arrives at your door within a few days. You collect your sample privately, at home, at your own pace, using the Teal Wand, a soft-tipped device about the same size and shape as a tampon applicator. Your sample goes to a lab for HPV testing, and a Teal provider reviews your results, which are then shared with you in your Teal patient portal, typically within about a week of your sample reaching the lab.
A few numbers worth knowing: 98% of Teal users describe the collection as painless, 91% finish in under five minutes, and the test detects cervical precancer with 96% sensitivity, the same as the in-clinic speculum collection method.
Above all, our SELF-CERV clinical study showed that it’s just as accurate as screening in-clinic with a provider. But with Teal there’s no clinic visit. No speculum. No waiting room.
A few common questions for first-time screeners
Do I need to already have an OB/GYN to use Teal?
No. Teal's telehealth platform covers the provider visit, the kit, the lab work, and the results review, without requiring an existing relationship with a gynecologist.
Do I need to have been sexually active to need this?
No. Screening is based on age and anatomy, not sexual history. Guidelines recommend screening for anyone with a cervix between 25 and 65, including people who've had the HPV vaccine.
Is it painful?
No. The Wand is designed to be gentle and easy to control, and if you have specific concerns, you can message a Teal provider directly through your portal.
If you're ready
However long it's been since you were supposed to screen, you’re here now, and there are comfortable, convenient options available to you.
If you want to understand exactly what to expect from a first screening with Teal, you can read more here. And if an at-home option sounds like something that could finally work for you, Teal is here.
