The American Cancer Society Updates Guidelines: Cervical Cancer Screening Start At 25, Not 21

A doctor prepare test for orange shirt patient.

In an update to cervical cancer screening guidelines, the American Cancer Society (ACS) recommends starting screenings at age 25. The previous guidelines released in 2012 called for cervical cancer screening starting at age 21.

The decision to raise the age for cervical cancer screenings is due to new data that suggests vaccination has led to a drop in rates of precancerous cervical changes, which are the precursors to cancer.

2020 Guideline Update:

  • For people aged 25 to 65 years, the preferred screening recommendation is to get a primary human papillomavirus (HPV) test every 5 years.
  • A primary HPV test is an HPV test that is done by itself for screening. The US Food and Drug Administration (FDA) has approved certain tests to be primary tests.
  • Women should get a co-test every 5 years that combines an HPV test with a Pap test or A pap test alone every 3 years.
  • People older than age 65 with a cervix stop being screened as long as they’ve had 10 years of regular screening with normal results. Otherwise, they should continue to be screened.
  • Those who have had their cervix removed don’t need screening
  • People who have gotten the HPV vaccine should still follow the screening guidelines as listed above.

What Is Cervical Cancer?

The cervix connects the uterus to the vagina. It’s part of the path babies pass through during birth. Cervical cancer is when cancer starts to form in the cells of the cervix.

What Is the Link Between HPV and Cervical Cancer?

Almost all cervical cancers are caused by an HPV infection. Most people don’t know they have HPV because the body can usually fight the infection before any symptoms occur. But high-risk types of HPV (such as HPV 16 and HPV 18) can cause serious pre-cancers and cancers of the cervix.

But HPV is not the only cause of cervical cancer. Not all women with HPV get cervical cancer, other risk factors, like smoking and HIV infection, influence which women exposed to HPV are more likely to develop cervical cancer.

What’s the Difference Between HPV Test and Pap Test?

The tests for cervical cancer screening are the HPV test and the Pap test.

  • The Pap test (also called a Pap smear) looks for changes in the cells that might be pre-cancer or cancer. The cells are examined under a microscope.
  • The HPV test looks in the cells for infection by high-risk types of HPV that are most likely to cause pre-cancer or cancer. The HPV test detects the presence of HPV virus which causes cervical cancer, but the test does not tell you if you actually have cancer.

Both types of screening tests, the HPV and Pap tests, require a small sample of cells from the cervix. A healthcare provider collects these by using a special, small tool to gently scrape or brush the cervix. The same set of cells is used for both tests.

Can Cervical Cancer Be Found Early?

Cervical cancer can often be found early, and sometimes even prevented, by having regular screening tests. If detected early, cervical cancer is one of the most successfully treatable cancers.

Can Cervical Cancer Be Prevented?

The two most important things you can do to prevent cervical cancer are to get the HPV vaccine if you are eligible, and to be tested regularly according to American Cancer Society (ACS) guidelines.

The most common form of cervical cancer starts with pre-cancerous changes and there are ways to stop this from developing. The first way is to find and treat pre-cancers before they become invasive cancers, and the second is to prevent the pre-cancers.

  • Get an HPV vaccine
  • Limit exposure to HPV
  • Use a condom
  • Don’t smoke

For more information about using the HPV test and the Pap test to prevent cervical cancer, see The American Cancer Society Guidelines for the Prevention and Early Detection of Cervical Cancer.


  • Cancer.org
  • Cnn.com

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