A study published August 27, 2026 in JAMA Network Open found that 31.9% of U.S. women aged 21 to 29 had never been screened for cervical cancer as of 2023 — up from 12.5% in 2005. The paper, "Rates of Never Receiving Cervical Cancer Screening Among US Women, 2005-2023," draws on National Health Interview Survey data, and Femtech Insider surfaced the findings to the industry on September 24. Cervical cancer is one of the most preventable cancers there is. The share of women who have never been checked for it has more than doubled in eighteen years.

Why It Matters

This is the denominator that every at-home HPV company has been pitching to investors, now measured in a peer-reviewed journal rather than estimated from a market-research deck. Roughly a third of women in their twenties represents a first-touch market that has never engaged with the existing clinical pathway at all — not lapsed, never started. For a self-collection business, a never-screened user is a fundamentally different acquisition problem than an under-screened one: there is no prior provider relationship to route around, no recall letter to piggyback on, and no established expectation of what the process should feel like. It also explains why the smart money in this category is selling to payers rather than consumers. Everlywell went to health plans; Teal is building its case around 2027 coverage and clinical-workflow integration. If the barrier is insurance and geography, a $99 DTC kit reaches the women who least need it while the never-screened cohort — disproportionately uninsured, Southern, without a degree — stays exactly where they are. The care-gap measure is the lever, because it gives a health plan a financial reason to mail a kit to someone who has never walked into a gynecologist's office. The unresolved piece is the back end: a positive self-collected HPV result still requires colposcopy at a physical clinic, in the same care deserts that produced the gap. Self-collection fixes the front door of a building that may not have enough rooms.

The pattern is not confined to the youngest cohort. Among women aged 30 to 65, the never-screened share rose from 5.3% to 14.8% over the same period — a smaller absolute number but the same directional failure. And it is unevenly distributed in ways that map onto access rather than attitude: 44.3% of Asian women and 37.5% of Hispanic women in their twenties reported never having been screened. Southern residents, uninsured women and women without college degrees were all more likely to have never been screened. The drivers cited are structural — care deserts, appointment availability, insurance access — rather than a sudden collapse in willingness to get a Pap test.

That distinction is the whole commercial story. A screening gap caused by reluctance is a marketing problem. A screening gap caused by the absence of a clinic within driving distance, an appointment inside three months, or an insurance card is a distribution problem — and distribution problems are what at-home self-collection was built to solve. Medscape framed the same data as "a lost generation in cervical cancer prevention" on September 21.

The supply side has moved fast enough that the timing is almost suspicious. Teal Health's FDA-authorized Teal Wand self-collection device is now available nationwide, and the company raised a $22M Series A on September 22 explicitly on the thesis that broader insurance coverage for self-collected screening arrives in 2027 following updated federal preventive-services guidance; it has also launched a UC Davis study evaluating the wand inside clinical workflows. Everlywell announced a partnership with Waters Corporation on September 16 to distribute an FDA-cleared at-home HPV self-collection kit — sold to health plans rather than direct to consumers, targeting the NCQA MY2026 CCS-E care-gap measure. In the UK, NHS England has announced a self-collection program aimed at women overdue for screening.

Sources

Update — 2026-09-25

{Initial entry — story first created.}