American Cancer Society updates cervical cancer screening guidelines

Volume 9, Issue 3, December 2020


Risk-based screening strategies combined with the HPV vaccine can dramatically reduce cancer rates.

Photograph of Tri A. Dinh, M.D.

Tri A. Dinh, M.D.

Cervical cancer used to be one of the most common cancers for women in the United States. But rates have been declining during the past decade. As a result, the American Cancer Society has updated its guidelines about when women should begin cervical cancer screening.

The updated guidelines recommend that women begin regular cervical cancer screenings with only a human papillomavirus (HPV) test starting at age 25, which is a few years later than previously recommended. Subsequent screenings should be performed every five years through age 65.

Alternate strategies suggest that women undergo only a Pap test by age 21, and both a Pap test and an HPV test starting at age 30. Subsequent testing should be based on the results and the testing strategy adopted by the patient and their health provider.

"Cervical cancer is a preventable cancer, which we have the potential to eradicate through screening tests and then also with the HPV vaccine," said Tri A. Dinh, M.D., a gynecologic oncologist at Mayo Clinic in Jacksonville, Florida.

More than 90% of cervical cancer is caused by HPV. About 80 million people are estimated to have been exposed to HPV, according to the U.S. Centers for Disease Control and Prevention.

An HPV test, which became available as part of screening for cervical cancer in 1999, can determine exposure to the virus. The Pap test, which has been used since the 1940s, identifies abnormal cells on the cervix.

"Both tests have value with respect to screening for cervical cancer, but strategies for preventing cervical cancer and guidelines may vary based on age, risk and other factors," Dr. Dinh said. "It's important to talk with your health care provider about options. Regardless of which screening approach you select, choose one and follow it."

The HPV vaccine is a great preventive measure for cervical cancer, Dr. Dinh said. "The majority of people get exposed to HPV in their late teens or early 20s, so that is why early immunization is such an important prevention measure," he said.

The HPV vaccine is approved for boys and girls beginning at age 9.