By DEVNA BOSE, Associated Press

The doctor is in — the mailbox, that is.

You can now do self-administered tests for everything from thyroid function to HIV in the privacy of your own home — and that list continues to grow, as the Food and Drug Administration recently approved the first at-home cervical cancer test.

While the tests can make it easier for people to access health care and can be helpful for those who have extreme anxiety about sensitive or invasive medical exams, experts warn that most of the tests cannot replace an actual in-person visit.

Here’s what doctors say you can test for at home, and when you should make the trek to your physician’s office.

What kinds of at-home tests are available?

There are two kinds at “at-home tests.”

In one type, the patient collects the sample and sends it off to a lab; the new cervical cancer test is like this.

The other gives an instant result — think COVID-19 and pregnancy tests.

What are the benefits of at-home tests?

HIV home-testing kits can improve rates of diagnosing sexually transmitted infections in rural communities and help people who are nervous about going to the doctor to seek a sensitive test, said Dr. Joseph Cherabie, an infectious diseases specialist in St. Louis.

“You really want to get people to care as quickly as possible, but some people could be very anxious about that results as well,” Cherabie said. “And they have very negative reactions.”

Labs are required to report a positive HIV test, instead of putting the onus on the patient who took the test, Cherabie said, and often the patient is matched up with HIV support services.

“If you are part of a sexual and gender minority community, going to a doctor’s office can be full of a lot of historical trauma, and you may prefer to just do testing at home without anyone judging you or asking you invasive questions about your sex life,” Cherabie said.

This photo provided by Teal Health in May 2025 shows the company’s Teal Wand self-collection device for at-home cervical cancer screening. (Nicole Morrison/Teal Health via AP)

The new cervical cancer test — which tests for strains of human papillomavirus, or HPV — involves a testing swab that’s like a tampon, said Dr. Susan Modesitt, a gynecologic oncologist at Emory University in Atlanta.

It is not, Modesitt said, a replacement for a Pap smear, the exam in which a metal speculum is inserted in the vagina to scrape cervix cells. A doctor’s visit also involves a pelvic exam, a chance to talk about abnormal bleeding — a sign of endometrial cancer — and other symptoms and issues, like menopause or STIs.

“There are so many other reasons to see your doctor and get an exam outside of a cervical cancer screening,” she said.

The at-home cervical cancer test from Teal Health requires a prescription, and the company said that results are not left for the patient to interpret.

I live in a rural area — can I take an at-home test?

Some at-home tests can replace a trip to the doctor’s office. That’s especially true in rural areas, where it can be difficult to get a colonoscopy.

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“The colonoscopy requires a pre-op, and you have to drive maybe 70 miles for it,” said Dr. Steven Furr, board chair of the American Academy of Family Physicians who practices in rural Alabama. “You get anesthesia. It’s actually almost like a surgical procedure in many ways.

“So, for a lot of people, that’s pretty arduous. That’s where an at-home test can come in handy.”

But, Furr said, if your test reveals issues, you need to go to your doctor. Plus, patients should always discuss test results with their physician instead of interpreting them on their own, he said.

Who shouldn’t do at-home tests?

If you have symptoms of what you’re testing for, go to the doctor.

At-home colon cancer tests aren’t the right option for people with a history of colon cancer or high-risk conditions, such as inflammatory bowel disease, said Dr. Zachariah Foda, a gastroenterologist at Johns Hopkins. He added that they’re also not recommended for people who are having GI symptoms.

While there are tests for many things — running anywhere from $15 to $400, depending on what is being evaluated — Furr said it’s essential to make sure that your test is FDA-approved so you can better trust the results.

“Anytime we get people involved in their own health care and help them understand what’s going on, I think that’s a good thing and it gives us a chance to talk,” he said. “Any kind of screening is better than no screening.”

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

The city of St. Paul plans to lease more than 10,000 square feet within the Osborn 370 building on Wabasha Street, covering the building’s entire ninth floor, for eight years. What will that square footage be used for? Therein lies the question.

The lease at 9 Fifth St. E., approved Wednesday by the St. Paul City Council, allows for flexible move-in dates and below-market rates, with the first 12 months rent-free. That gives the city some time to complete a “space use” study with the help of real estate consultants, who will attempt to determine which city offices will make best use of the new floor and in what manner.

It might become collaborative work space for the city to engage with private sector partners, or it may support departments with space shortages, such as the city attorney’s office.

It also may be used as upgraded space for staff committed to working downtown more than three days per week, said Bruce Engelbrekt, the city’s real estate manager, addressing the city council on Wednesday.

City offices

With many office staff on a hybrid work schedule, St. Paul Mayor Melvin Carter floated the idea last year of clearing out the downtown City Hall Annex building on Fourth Street and converting the property into residences, which remains a possibility.

“We’re trying to think strategically about how to use our purchasing power and people power to help be part of the solution,” said Council President Rebecca Noecker.

City offices are largely but not exclusively spread throughout the City Hall/Ramsey County Courthouse building at 15 West Kellogg Blvd. and the annex building directly across the street.

The city’s Department of Safety and Inspections works out of a building on Jackson Street, which is owned by Madison Equities, an embattled downtown property owner that has recently lost control of some of its buildings to foreclosure and receivership.

‘Minimal upfront investments’

The study likely will at least touch on library staff based at the downtown George Latimer Central Library.

“We have a question into (the consultants) whether the mayor’s office and the city council offices should be part of the study, because of your need to be located in this building,” Engelbrekt said. “We need to specifically look at those (offices) that have some space needs.”

Council Member Cheniqua Johnson noted Osborn 370 has developed a positive reputation downtown, drawing notable tenants such as the St. Paul and Minnesota Foundation.

The Osborn 370 floor is partially furnished, allowing “minimal up-front investment to move and establish operations,” according to the council resolution approved Wednesday.

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By MATT OTT, AP Business Writer

WASHINGTON (AP) — The average rate on a 30-year mortgage in the U.S. fell this week for the first time in a month, but borrowing costs for homebuyers remain elevated.

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The long-term rate dipped to 6.85% from 6.89% last week, mortgage buyer Freddie Mac said Thursday. A year ago, the rate averaged 6.99%.

Borrowing costs on 15-year fixed-rate mortgages, popular with homeowners refinancing their home loans, also came down. The average rate fell to 5.99% from 6.03% last week and 6.29% a year ago, Freddie Mac said.

Mortgage rates are influenced by several factors, from the Federal Reserve’s interest rate policy decisions to bond market investors’ expectations for the economy and inflation. The key barometer is the 10-year Treasury yield, which lenders use as a guide to pricing home loans.

Bond yields have retreated the past week but broadly have been trending higher since hitting 2025 lows in early April, reflecting investors’ uncertainty over the Trump administration’s ever-changing tariffs policy and worry over exploding federal government debt.

The 10-year Treasury yield was 4.39% in midday trading Thursday, down from 4.54% a week ago.

By MICHAEL R. SISAK

NEW YORK (AP) — Six weeks before UnitedHealthcare CEO Brian Thompson was gunned down outside a Manhattan hotel in December, suspect Luigi Mangione mused about rebelling against “the deadly, greed fueled health insurance cartel” and said killing the executive “conveys a greedy bastard that had it coming,” prosecutors revealed Wednesday.

The Manhattan district attorney’s office quoted extensively from Mangione’s handwritten diary — highlighting his desire to kill an insurance honcho and praise for Ted Kaczynski, the Unabomber — as they fight to uphold his state murder charges. They also cited a confession they say he penned “To the feds,” in which he wrote that “it had to be done.”

Mangione’s lawyers want the state case thrown out, arguing in court papers that those charges and a parallel federal death penalty case amount to double jeopardy.

They also want state terrorism charges dismissed, have asked for the federal case to go first and say prosecutors should be barred from using evidence collected during Mangione’s arrest, including a 9mm handgun, statements to police and the diary.

Manhattan prosecutors contend that there are no double jeopardy issues because neither case has gone to trial and because the state and federal prosecutions involve different legal theories.

His lawyers say that has created a “legal quagmire” that makes it “legally and logistically impossible to defend against them simultaneously.”

The state charges, which carry a maximum of life in prison, allege that Mangione wanted to “intimidate or coerce a civilian population,” that is, insurance employees and investors. The federal charges allege that Mangione stalked an individual, Thompson, and do not involve terror allegations.

Mangione, 27, has pleaded not guilty in both cases. No trial dates have been set.

Mangione’s “intentions were obvious from his acts, but his writings serve to make those intentions explicit,” prosecutors said in Wednesday’s filing. The writings, which they sometimes described as a manifesto, “convey one clear message: that the murder of Brian Thompson was intended to bring about revolutionary change to the healthcare industry.”

They quoted excerpts in which Mangione discussed options for the attack, such as bombing UnitedHealthcare’s headquarters, before deciding to target the company’s investor conference in Manhattan. He wrote about plans to “wack the CEO at the annual parasitic bean-counter convention” because it was “targeted, precise and doesn’t risk innocents.”

UnitedHealthcare, the largest U.S. health insurer, “literally extracts human life force for money,” Mangione wrote, envisioning the news headline, “Insurance CEO killed at annual investors conference.”

The company has said he was never a client.

Mangione is due back in state court June 26, when Judge Gregory Carro is expected to rule on his request for dismissal.

His lawyers asked Tuesday for his handcuffs and bulletproof vest to be removed during the hearing. They called him a “a model prisoner, a model defendant” and said the security measures would suggest to potential jurors that he is dangerous. Carro has not ruled on that.

Mangione’s next federal court date is Dec. 5, a day after the one-year anniversary of Thompson’s death.

Surveillance video showed a masked gunman shooting Thompson from behind as he arrived for the conference Dec. 4 at the New York Hilton Midtown. Police say “delay,” “deny” and “depose” were scrawled on the ammunition, mimicking a phrase commonly used to describe how insurers avoid paying claims.

Mangione was arrested Dec. 9 at a McDonald’s in Altoona, Pennsylvania, 230 miles (about 370 kilometers) to the west, and he is being held in a federal jail in Brooklyn.

Manhattan District Attorney Alvin Bragg has called the ambush “a killing that was intended to evoke terror.”

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U.S. Attorney General Pam Bondi announced in April that she was directing federal prosecutors to seek the death penalty for “an act of political violence” and a “premeditated, cold-blooded assassination that shocked America.”

The killing and ensuing search for Mangione rattled the business community while galvanizing health insurance critics who rallied around him as a stand-in for frustrations over coverage denials and hefty bills. Supporters have flocked to his court appearances and flooded him with mail.

Mangione “demonstrated in his manifesto that he was a revolutionary anarchist who would usher in a better healthcare system by killing the CEO” of one of the biggest U.S. companies, prosecutors wrote. “This brutal, cowardly murder was the mechanism that defendant chose to bring on that revolution.”