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Cervical cancer screening guidelines: Who, why and when


If cervical cancer screening is on your mind, there’s likely a reason for it. Perhaps you’ve turned 21 and learned that your next checkup will include a cervical cancer screening (with a Pap test). Maybe you’ve passed your 30th birthday and your doctor is now recommending testing for the human papillomavirus (HPV) as well. Or it could be that you’re overdue for a doctor’s visit and trying to figure out which preventive health screenings you need.

So, what should you know about cervical cancer screening? Below, we share the most important details about testing options and when to start.

Why regular cervical cancer screenings are so important

Cervical cancer develops in the cells of the cervix – the part of the uterus that connects to the vagina. Anyone with a cervix can get this type of cancer, but it’s possible to prevent cervical cancer or find it in its precancerous stage.

In fact, thanks to routine cervical cancer screenings and the HPV vaccine, there’s been a significant decrease in the number of people getting cervical cancer or dying because of it.

How the HPV vaccine reduces risk of cervical cancer

Most cervical cancer is the result of a persistent infection with the human papillomavirus (HPV) – a common virus that can spread during sexual contact with someone who has it. Most sexually active people will get HPV at some point in their life.

HPV infections usually go away on their own within two years. But if an infection doesn’t go away, it can cause health problems like genital warts and cervical cancer. Persistent HPV infection can also lead to other cancers, including cancer of the vulva, vagina, penis and throat.

If you’re vaccinated against HPV, your chance of getting cervical cancer is drastically lower. This is true, no matter which formula of the HPV vaccine you receive.

Nearly everyone between the ages of 9 and 26 should get the HPV vaccine. If you’re age 27-45, talk to your doctor to see if vaccination is right for you. While the HPV vaccine is the best way to prevent cervical cancer, it’s still possible to get cervical cancer after being vaccinated since the vaccine doesn’t prevent infection from all high-risk types of HPV. That’s why cervical cancer screenings are recommended for all women (and those with a cervix).

Cervical cancer screening guidelines: The timing and types change with age

Routine cervical cancer screenings are recommended between the ages of 21 and 65. If you’re between 21 and 29 years old, it’s generally recommended that you get cervical cytology (commonly known as a Pap test) every three years. If you’re between the ages of 30 and 65, there are different testing options. For example, your doctor may recommend you also get an HPV test. The combination of cervical cytology and HPV testing is called co-testing.

Your doctor may recommend different timing based on your health and past screening results. They may also recommend that you start screening sooner or continue for longer.

How to test for cervical cancer

There are two main tests used for cervical cancer screening. The difference between the tests is how your cells are processed and evaluated.

How your doctor collects cervical cells for screening

Your doctor uses a soft brush to collect cervical cells as part of a pelvic exam. If you’ve never had a pelvic or speculum exam before, you might feel nervous. Talk to your doctor beforehand if you have any questions or concerns.

Some people feel embarrassed or awkward during the exam, and that is totally normal. But the exam shouldn’t be painful. If it hurts, tell your doctor. They’ll stop the exam and figure out how to create a more comfortable experience for you.

After the exam, your doctor will send the sample to a lab for testing. The same sample can be used for both cervical cytology and HPV testing.

Cervical cytology looks for cell changes

If your doctor collects cells for cervical cytology, they’ll be colored with special stains and then looked at under a microscope to see if they are normal in appearance. The test can find changes that could turn into cervical cancer if left untreated. It can also find precancerous cells and cervical cancer cells.

HPV test for cervical cancer looks for DNA

The HPV test looks for infection with high-risk types of HPV that are linked to cervical cancer. If your screening includes an HPV test, the lab will look at cervical cells to see if they contain pieces of DNA from high-risk HPV.

What to know about cervical cancer screening results

Cervical cytology (Pap test) results can be either normal or abnormal. An abnormal result doesn’t mean that you have cancer. If you have an HPV test, the result will be either positive or negative. If it’s positive, the test will also identify the specific type of HPV.

Additional testing for cervical cancer

If your doctor has any concerns about your results, they’ll contact you about the next steps. This could be to repeat cervical cytology (with or without HPV testing). They may also recommend a test called a colposcopy. During a colposcopy, a doctor looks at your cervix using a portable microscope and takes small tissue samples (called biopsies) that are sent to a lab for testing.

Even if your cervical cancer screening results are normal or negative, it’s still important to keep up with screening recommendations because your cells can change over time.

Take steps to prevent cervical cancer

The best way to prevent cervical cancer is to get the HPV vaccine. If you haven’t been vaccinated and are 45 years old or younger, talk to your doctor about getting vaccinated. It’s best to get the vaccine before you become sexually active. But the vaccine can still reduce your risk of cervical cancer even if you’ve had sex or a positive HPV test result in the past.

If you are 21 or older, getting routine cervical cancer screening is the best way to detect abnormal cells and prevent cervical cancer. Getting screened is easy – you don’t need to make an extra appointment. Your OB-GYN or primary care doctor can screen you at your next preventive checkup. And if you’re still looking for a doctor, we have hundreds of award-winning doctors to choose from.

Cervical cancer screenings are usually 100% covered by insurance, meaning there shouldn’t be any cost to you. If you don’t have insurance, or if your insurance doesn’t cover screening exams, it’s possible you may qualify for free screening through the National Breast and Cervical Cancer Early Detection Program.

Also, be on the lookout for symptoms of cervical cancer, such as vaginal bleeding after sex, following menopause or between periods. Heavy bleeding during periods, smelly vaginal discharge and pain during sex are other symptoms. If you think you have signs of cervical cancer, schedule a primary care appointment.



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