Your guide to cervical cancer screening

Cervical cancer screening has come a long way. The Pap test, invented by Dr. George Papanicolaou in the 1920s, was the first widely adopted test to detect cervical cancer and precancers.

In the 1980s, researchers discovered that human papillomavirus (HPV) causes more than 90% of cervical cancers. This breakthrough paved the way for new preventive tools, including the HPV vaccine and the HPV test.

Today, cervical cancer screening continues to evolve with new testing options and updated recommendations. Whether you’re due for your first Pap test or wondering how often you should be screened, here’s what you need to know.

Why screening matters

Cervical cancer often doesn’t cause symptoms until it has advanced. Screening can detect cancer early, when it’s usually easier to treat. It can even find precancerous changes years before cancer develops.

Despite strong evidence supporting screening, more than half of new cases occur in people who are not screened as recommended.

“With regular screening, most cases can be found early or prevented altogether,” says Dr. Danny Younes, an OBGYN with Sharp Rees-Stealy Medical Group. “Early detection can significantly improve outcomes.”

HPV and cervical cancer

Nearly all cervical cancers are caused by HPV — the most common sexually transmitted infection in the U.S.

There are more than 200 kinds of HPV. Two in particular, types 16 and 18, lead to the majority of cervical cancer cases. These are called high-risk HPV.

“Most HPV infections clear on their own, but persistent high-risk HPV increases cancer risk,” Dr. Younes says. “Detecting HPV early means that any cervical cell changes can be monitored and, if required, treated before they turn into cancer.”

Types of screening

There are two screening tests for cervical cancer. They can be done on their own or together, called co-testing. Both tests involve collecting a small sample of cells from the cervix — the lower part of the uterus — but they look for different things.

• Pap test: Checks for abnormal cells that could turn into cervical cancer if not treated.

• HPV test: Looks for high-risk types of HPV that can cause those cell changes.

Screening recommendations by age

Screening frequency depends on your age and health history. In most cases, routine screening is not needed every year.

These general guidelines apply to people at average risk. Talk with your doctor about what’s right for you. If you’ve had an abnormal result or have other risk factors, your doctor may recommend a different schedule.

In your 20s
You don’t need your first Pap test until age 21, even if you’re sexually active before then. If results are normal, you should get a Pap test every three years until age 30.

Ages 30 to 65
HPV testing alone, also known as primary HPV testing, is now considered the preferred screening approach for this age group. Talk with your doctor about which testing option is right for you.

• HPV test only (primary HPV testing): If the results are normal, you can wait five years before your next screening.

• HPV and Pap test (co-testing): If both results are normal, you can wait five years before your next screening.

• Pap test only: If the result is normal, you can wait three years before your next Pap test.

After age 65
Screening usually stops after age 65 if you have a history of regular screening with normal results.

At all ages
People who had their cervix and uterus removed (hysterectomy) usually do not need further cervical cancer screening. Check with your doctor to confirm.

New options for HPV testing

Some people may be able to collect their own sample for HPV testing, either at home or in a health care setting. Studies show that self-collected HPV tests are as accurate as clinician-collected samples and could help reduce barriers to screening.

Self-collection can be a great option for people ages 30 to 65 who are due for routine cervical cancer screening and prefer a more private or comfortable experience. People who collect their own samples for HPV testing and have normal results should be screened again in three years.

Don’t skip screenings — even if you’re vaccinated

The HPV vaccine protects against the types of HPV most likely to cause cervical cancer, but it doesn't cover every strain. Even if you have been vaccinated, it’s important to follow screening guidelines for your age group.

“OBGYNs and primary care doctors play an important role in preventing disease and supporting overall health,” Dr. Younes says. “Regular wellness visits are a chance to stay on track with recommended screenings and talk about ways to reduce your risk and support your long-term health.”

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