The American Cancer Society Guideline for Cervical Cancer Screening
The American Cancer Society (ACS) recommends that women and other individuals with a cervix follow this guideline to help find cervical cancer early. Following this guideline can also help find cervical precancers, which can be treated before they become cervical cancer.
The cervix is the bottom part of the uterus that connects it to the vagina. Nearly all cervical cancers are caused by long-lasting infection with certain types of human papillomavirus (HPV).
ACS screening recommendations
Women and other individuals with a cervix at average risk for cervical cancer (see below) should start screening at age 25 and continue until at least age 65.
Screening should be done every 3 to 5 years, depending on the test:
Primary HPV testing, every 5 years
The preferred screening option is primary HPV testing (testing only for HPV infection) on a cervical sample collected by your health care provider. This test should be done every 5 years.
Other testing options
Other options for cervical cancer screening include:
- Self-collected* HPV testing, every 3 years: For this test, you collect your own testing sample by inserting a soft swab into your vagina. It can be done privately in a clinic, a doctor’s office, or at home. A health care provider still needs to order the test, and it should be done every 3 years.
- Co-testing, every 5 years: In some places, HPV testing is combined with a Pap test, which is a test that looks at cervical cells under a microscope. Your health care provider collects the cervical sample for this type of testing. It should be done every 5 years.
- Pap test alone, every 3 years: If none of the other approaches are an option, you can be screened with a Pap test alone every 3 years.
*Self-collection should only be done using tests and collection devices approved by the US Food and Drug Administration (FDA). These are only available through your health care provider.
See below for more on these testing options.
Getting screened regularly is the most important thing, no matter which test you get.
When can cervical cancer screening be stopped?
You should only stop screening if you’ve been getting screened regularly. You can stop cervical cancer screening at age 65 if your most recent screening tests have been normal.
If I’m 65 or older, how many normal tests do I need before I can stop screening?
This depends on the type of screening test.
- HPV testing collected by a provider every 5 years: You can stop screening at age 65 if your last 2 tests have been normal.
- Co-testing using HPV and Pap tests every 5 years: You can stop screening at age 65 if your last 2 tests have been normal.
- Self-collected HPV testing every 3 years: You can stop testing at age 65 if your last 2 tests have been normal.
- Pap tests every 3 years: You can stop testing at age 65 if your last 3 Pap tests have been normal.
What if I don't know when I was last screened?
If you or your health care provider aren’t sure when you had your last cervical cancer screening, you should keep getting screened after age 65 until you have 2 normal HPV tests or 3 normal Pap tests in a row.
What if my life expectancy is limited?
If your life expectancy is limited for any reason, you can stop screening for cervical cancer at any time.
Who should follow this guideline?
This guideline applies to women and other individuals with a cervix who are at average risk for cervical cancer.
This includes you if all of the following are true:
You have a cervix. Everyone who has a uterus also has a cervix. If you’ve had a total hysterectomy (removal of the uterus and cervix), you don’t need screening anymore, unless the surgery was done for cancer or a precancerous problem. If your cervix was not removed (for example, if you had a partial hysterectomy) you still need screening. Ask your health care provider if you’re not sure.
You don’t have symptoms that could be related to cervical cancer, such as vaginal bleeding when you don’t have your period, vaginal discharge, or pain in your pelvis. If you have symptoms and you’re not sure what they mean, talk with your health care provider as soon as possible.
You’ve never had an abnormal cervical cancer screening (HPV or Pap) test, or if you did, your results have been normal for many years. If you’ve had abnormal screening test results in the past, your health care provider will help you determine the screening plan that’s best for you.
This guideline applies to you even if:
- You’ve received the HPV vaccine. Getting the HPV vaccine greatly reduces your risk of cervical cancer, but it doesn’t eliminate it completely.
- You’re in a long-term relationship with the same partner, you’ve stopped having children, you don’t have sex with men, or you’re not sexually active. While HPV is most often transmitted through sex, HPV infections that cause cervical cancer can sometimes appear decades after you were first exposed.
- You’re in menopause. Cervical cancer risk increases with age, so it’s very important to keep screening through at least age 65 even if your periods have stopped.
Who might need a different screening plan?
You might need a different screening plan, such as being screened more often, if you are at higher risk of cervical cancer.
You may be at increased risk if:
- You’ve had previous abnormal screening test results or cervical precancer.
- You’ve had cervical cancer in the past.
- You’re at higher risk for cervical cancer because you have a weakened immune system. This could be from an organ or stem cell (bone marrow) transplant, human immunodeficiency virus (HIV) infection, a medicine you take that weakens your immune system, or some other cause.
- You were exposed to diethylstilbestrol (DES) before birth.
If any of these apply to you, talk to your health care provider about the best screening plan.
Understanding tests for cervical cancer screening
Two types of tests can be used to screen for cervical cancer and precancers: the HPV test and the Pap test.
HPV test
The HPV test looks for infection by high-risk types of human papillomavirus (HPV), the virus that causes nearly all cervical precancers and cancers. The test can be done in 2 ways:
During a speculum exam, a health care professional collects a sample of cervical cells by gently scraping or brushing your cervix with a special tool.
This is the preferred way to screen for cervical cancer or precancer because the lab can do further testing on the cervical cells if anything abnormal is found. If the test is negative (normal), the ACS recommends that you repeat the test in 5 years.
You can collect your own sample for HPV testing using a soft swab to collect cells from your vagina. This can be done privately in a clinic setting or at home, without a health care provider present. A health care provider will still need to order the test for you.
- If this test is negative (normal), the ACS recommends that you repeat the test in 3 years.
- If the test shows anything abnormal, you will need to see your health care provider again for a speculum exam to collect cervical cells for further tests or follow-up procedures.
Why sample collection by a health care provider is preferred
Some people may be more comfortable with collecting their own vaginal sample for HPV testing. But if a self-collected HPV test result is positive (abnormal), you’ll need to see a health care provider, who will collect a new sample from your cervix for more testing.
HPV tests done using a cervical sample collected by a health care professional are preferred because if the test is positive, the lab can run more tests on that same sample to help determine the next steps for you.
Note about HPV tests ordered online: HPV tests that you can order yourself off the internet may not be good quality. ACS recommends using only tests and collection devices approved by the US Food and Drug Administration (FDA). These are only available through your health care provider.
Pap test
The Pap test lets a doctor look at the cells taken from your cervix to find changes that might be cancer or precancers.
This test is done with a sample collected by a health care professional during a speculum exam, using a special tool to gently scrape or brush your cervix to remove a sample of cells for testing. If the test is negative, it should be repeated every 3 years.
The Pap test has been used for a long time, but HPV testing is now preferred because it leads to finding more precancers earlier. But if none of the options for HPV testing are available, screening using a Pap test is acceptable.
Co-testing with HPV and Pap tests
Some HPV tests are FDA-approved to be used only as part of a co-test, in which an HPV test and a Pap test are done at the same time.
Doing a co-test does not add much benefit compared with HPV testing alone. But a primary HPV test (HPV alone) may not be available in some settings, so co-testing every 5 years is still acceptable for screening. The sample for co-testing is collected from the cervix during a speculum exam by a health professional.
Benefits and possible harms of cervical cancer screening
The goal of cervical cancer screening is to find precancer or cancer when it’s more treatable and curable than advanced cancer. Regular screening has been shown to prevent more than 8 out of 10 cervical cancers, as well as find some cancers early, and save lives.
While these tests prevent many cervical cancers, no medical test is perfect:
- Sometimes a test might suggest that there is a precancer when there isn’t one. This is known as a false positive result.
- Some cell changes that are found with these tests will never become cervical cancer, but they might still result in further tests and treatments.
- Cancer might also develop in someone who’s had negative screening test results, although this is very rare.
What if my screening test is positive (abnormal)?
If you have a positive HPV test or abnormal Pap test, you will need further testing or procedures.
A positive test does not mean you have cancer. Most abnormal results turn out not to be cancer, but they need to be investigated to be sure. Talk with your health care provider about the next steps for you.
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- References
Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
American Cancer Society. Cancer Prevention & Early Detection Facts & Figures 2023-2024. American Cancer Society, Atlanta, Ga. 2023. American Cancer Society. Cancer Prevention & Early Detection Facts & Figures 2023-2024. Atlanta, Ga: American Cancer Society; 2023.
Fontham, ETH, Wolf, AMD, Church, TR, et al. Cervical Cancer Screening for Individuals at Average Risk: 2020 Guideline Update from the American Cancer Society. CA Cancer J Clin. 2020. https://doi.org/10.3322/caac.21628.
Last Revised: December 4, 2025
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