Cervical Cancer Screening for Individuals at Average Risk

Patient Guideline Summary

Publication Date: July 29, 2020

Last Updated: November 21, 2023

Objective

This patient summary means to discuss key recommendations from the American Cancer Society for Cervical Cancer Screening for Individuals at Average Risk. It is limited to adults 18 years of age and older and should not be used as a reference for children.

Overview

Cervical cancer can be detected even before it becomes cancer by sampling cells from the cervix, a test known as a Pap smear.

Human papillomavirus (HPV) infection is the main cause of cervical cancer.
- HPV is a sexually transmitted germ.
- HPV can be detected by a simple screening test.

This patient summary focuses on screening women for early signs of cervical cancer.

Diagnosis

Pap smears (cytology) and HPV screening should begin for all women at age 25 and repeat every 5 years until age 65.
If primary HPV testing is not available, individuals aged 25 to 65 years should be screened with cotesting (HPV testing in combination with cytology) every 5 years or cytology alone every 3 years.

When to Stop Cervical Cancer Screening

It is recommended that individuals with a cervix who are older than age 65 years, who have no history of CIN2+ (a positive Pap smear) within the past 25 years, and who have documented adequate negative prior screening in the prior 10 years to discontinue cervical cancer screening of any kind.
- Adequate negative prior screening is currently defined as 2 consecutive negative HPV tests, or 2 consecutive negative cotests, or 3 consecutive negative cytology tests within the past 10 years, with the most recent test occurring within the recommended interval for the test used. Note: These criteria do not apply to individuals who are currently under surveillance for abnormal screening results.
- Cervical cancer screening may be discontinued in individuals of any age with limited life expectancy.

Abbreviations

ACS: American Cancer Society
CIN: Cervical Intraepithelial Dysplasia
HPV: Human Papilloma Virus

Source Citation

Fontham ETH, Wolf AMD, Church TR, Etzioni R, Flowers CR, Herzig A, Guerra CE, Oeffinger KC, Shih YT, Walter LC, Kim JJ, Andrews KS, DeSantis CE, Fedewa SA, Manassaram-Baptiste D, Saslow D, Wender RC, Smith RA. Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society. CA Cancer J Clin. 2020 Sep;70(5):321-346. doi: 10.3322/caac.21628. Epub 2020 Jul 30. PMID: 32729638.

Disclaimer

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.