Cervical Cancer Screening Guide
Last Updated: February 18, 2026
Regular cervical cancer screening is one of the most successful cancer prevention strategies available. When detected early through screening, cervical cancer is highly treatable, and precancerous changes can be addressed before they develop into cancer.
Why Screening is Important
Cervical cancer screening can prevent most cervical cancers by finding precancerous cells that can be treated before they turn into cancer. It can also find cervical cancer early when treatment is most likely to be successful.
Since widespread screening began, cervical cancer rates have decreased by more than 60% in the United States. Women who are regularly screened have significantly better outcomes compared to those who are not screened or screened infrequently.
Types of Screening Tests
Pap Test (Pap Smear)
The Pap test checks for cellular changes in the cervix that could develop into cervical cancer if not treated. During a Pap test, a healthcare provider collects cells from your cervix using a small brush or spatula. These cells are then examined under a microscope for abnormalities.
- Detects precancerous and cancerous cells
- Quick procedure, usually taking less than 5 minutes
- May cause mild discomfort but should not be painful
- Results typically available within 1-3 weeks
HPV Test
The HPV test looks for the presence of high-risk HPV types that can cause cervical cancer. The sample is collected the same way as a Pap test, often at the same time. The HPV test identifies whether you have one of the HPV types most likely to cause cervical cancer.
- Detects high-risk HPV infections
- Can be done alone or with a Pap test
- More sensitive than Pap test alone
- Results typically available within 1-3 weeks
Co-Testing
Co-testing involves doing both a Pap test and HPV test at the same time using the same sample. This approach provides the most comprehensive screening and is an option for women ages 30-65.
Screening Guidelines by Age
Under Age 21
Screening is not recommended, regardless of sexual history. Cervical cancer is extremely rare in this age group, and most HPV infections in young women clear on their own.
Ages 21-29
Recommended: Pap test every 3 years
HPV testing alone or co-testing is not recommended for this age group because HPV infections are common and usually clear on their own in younger women.
Ages 30-65
Recommended options:
- HPV test alone every 5 years (preferred)
- Co-testing (Pap test + HPV test) every 5 years
- Pap test alone every 3 years (acceptable)
Starting at age 30, HPV testing becomes more useful because persistent HPV infections are more likely to lead to cervical cancer in this age group.
Over Age 65
Women over 65 who have had adequate screening with normal results may stop screening. You should continue screening if:
- You have not had adequate screening in the past 10 years
- You have a history of cervical precancer or cancer
- You are at high risk due to immunosuppression or other factors
After Hysterectomy
If you've had a hysterectomy with removal of the cervix and no history of cervical cancer or serious precancer, you do not need screening. However, if your cervix was not removed or you have a history of cervical cancer or precancer, continue screening as recommended by your healthcare provider.
Special Situations
HIV-Positive Women
Women with HIV should begin screening within one year of becoming sexually active but no later than age 21. Initially, screening should be done twice in the first year after diagnosis, then annually if results are normal.
Women with Weakened Immune Systems
Women who have had an organ transplant, are on chronic steroid therapy, or have other conditions affecting the immune system may need more frequent screening. Discuss the appropriate schedule with your healthcare provider.
History of Cervical Cancer or Precancer
Women who have been treated for cervical precancer or cancer need more frequent screening for at least 25 years after treatment, even if screening extends past age 65.
DES Exposure
Women whose mothers took DES (diethylstilbestrol) during pregnancy may need more frequent screening and should discuss their screening schedule with their healthcare provider.
Understanding Your Results
Normal Results
A normal result means no cell changes or HPV infection was found. Continue screening according to the recommended schedule based on your age and test type.
Abnormal Pap Test Results
An abnormal Pap test does not mean you have cancer. There are different types of abnormal results:
- ASC-US (Atypical Squamous Cells of Undetermined Significance): Mild changes that often resolve on their own. HPV testing may be recommended.
- LSIL (Low-grade Squamous Intraepithelial Lesion): Mild cell changes often caused by HPV. May be monitored or further evaluated with colposcopy.
- HSIL (High-grade Squamous Intraepithelial Lesion): More serious changes that are more likely to progress to cancer if untreated. Requires further evaluation.
- AGC (Atypical Glandular Cells): Abnormal cells from the upper part of the cervix or uterus. Requires further evaluation.
Positive HPV Test
A positive HPV test means you have an HPV type that can cause cellular changes. This does not mean you have or will definitely develop cervical cancer. Many HPV infections clear on their own. Your healthcare provider will recommend next steps, which may include:
- Repeat testing in one year
- Immediate colposcopy
- Additional testing to check for specific high-risk HPV types
Follow-Up Tests and Procedures
Colposcopy
A colposcopy is a procedure where your healthcare provider uses a special magnifying instrument called a colposcope to examine your cervix more closely. If abnormal areas are seen, a small tissue sample (biopsy) may be taken. The procedure typically takes 10-20 minutes and is performed in your provider's office.
Biopsy
If abnormal areas are identified during colposcopy, a small sample of tissue may be removed for laboratory examination. This is the only way to definitively determine whether precancerous or cancerous cells are present.
Preparing for Your Screening
To ensure the most accurate results, follow these recommendations before your screening:
- Schedule your appointment when you're not having your period
- Avoid intercourse for 2 days before the test
- Do not use tampons for 2 days before the test
- Do not use vaginal creams, medications, or spermicides for 2 days before the test
- Do not douche for 2 days before the test
Barriers to Screening and How to Overcome Them
Don't Delay Your Screening
Regular cervical cancer screening saves lives. If you're due for screening or it's been more than the recommended time since your last test, make an appointment today.
Need help finding a screening location? Visit our Resources page for information about affordable screening options in your area.
Medical Disclaimer: This information is for educational purposes only. Screening recommendations may vary based on individual risk factors. Always consult your healthcare provider to determine the most appropriate screening schedule for you.