Cervical Cancer Screening: How Often Should You Get Tested?
The two smartest things you can do to help prevent cervical cancer are to get the human papillomavirus (HPV) vaccine, and to get the right test at the right time.
Cervical cancer rates have dropped dramatically in the US over the past few decades. This is largely due to increased screening through Pap and HPV testing. Those tests can find warning signs of cancer before it even develops.
It's clear that screening saves lives. But many people may be unsure how often they should be tested—or which tests they need. That's because cervical cancer screening recommendations have changed in recent years.
Common Screening Tests for Cervical Cancer
Two tests are widely used to screen for cancer in the cervix, the narrow opening to the uterus at the top of the vagina:
- The Papanicolaou (Pap) test can find abnormal cells early, before they turn into cancer.
- The HPV test looks for the virus that is the main cause of cervical cancer.
- Pap and HPV co-tests combine Pap and HPV testing.
Screening with Pap tests has played a major role in preventing and detecting cervical cancer for decades. But Pap tests need to be repeated often, and they can also lead to false positives. That can lead to unneeded follow-up tests and stress for people whose Pap tests detect abnormal cells that are unlikely to lead to cancer.
Studies have found that HPV tests can detect precursors to cervical cancer more accurately than Pap tests. And they don't need to be repeated as often. That's led to new advice for cancer screening.
When Should You Get Screened for Cervical Cancer?
The American Cancer Society updated their screening guidelines in 2020.
These guidelines are designed to avoid unnecessary testing for women whose test results are normal or show only mild, or low-grade, abnormal cells. For individuals with a cervix, here’s what you need to know:
If you are…
American Cancer Society Cervical Cancer Screening Guidelines say…
25 – 65 years old
- Get a primary HPV test every 5 years
OR if a primary test is not available,
- Get an HPV/Pap co-test every 5 years or a Pap test alone every 3 years
Age 66 or older
Stop getting HPV and/or Pap tests if you've had normal screening results for the past 10 years and you have no history of moderate or severe abnormal cells for the past 25 years.
There are a number of organizations that provide screening recommendations for cervical cancer. While the ACS has recently updated their recommendations to the above, other organizations may recommend a different timeline, such as screening women ages 21 through 29 with a Pap test alone every 3 years and women ages 30 through 65 with either a primary HPV test every 5 years, a Pap test and HPV test (co-test) every 5 years, or a Pap test alone every 3 years.
It is important to have a conversation with your physician about what cervical cancer screening schedule you should follow.
What if You've Had the HPV Vaccine?
The HPV vaccine is incredibly effective. It can prevent more than 90% of the cancers linked to HPV. But it's still possible to get HPV and to develop cervical cancer. If you have had the HPV vaccine, you should still follow the screening guidelines for your age group.
When is More Frequent Cervical Cancer Testing Needed?
Some women have health issues that put them at higher risk for cervical cancer. You may need to be screened more often – and followed more closely by your doctor – if you:
- Have a history of cervical cancer or abnormal pap tests
- Are infected with HIV (human immunodeficiency virus) or have a weakened immune system
- Were exposed to DES (diethylstilbestrol) before birth
Do You Need to Be Screened for Cervical Cancer if You've Had a Hysterectomy?
If you've had a hysterectomy (surgery to remove your uterus), you may still need cervical or vaginal cancer screening. It depends on several factors. You are more likely to need screening if:
- Your cervix was not removed as part of your surgery
- You had the hysterectomy to remove abnormal or cancerous cells
- You have high-risk HPV infection
Even if your cervix was removed, there may still be some cervical cells at the top of the vagina. Your doctor can help you decide when to stop screening.
The Importance of Routine Screening
Cervical cancer screening can find cancer early, when it may be easier to treat. And finding and treating precancer cell changes can prevent cervical cancer from developing. If you're due for a cervical cancer screening, don't wait.