Cervical Cancer Screening Guidelines

Screening Recommendations

Women at age 64 should continue cervical cancer screening with both Pap and HPV testing until age 65, as long as they are in good health and have not had adequate prior negative screening, according to the American Cancer Society 1
The American Cancer Society recommends that women who have an intact cervix and are in good health should continue cervical cancer screening until age 70 years, after which they may elect to stop screening if specific criteria are met 2, 3, 4, 5
For women aged 30-65, the preferred screening approach is either Pap test plus HPV DNA test every 5 years or Pap test alone every 3 years, as recommended by the American College of Obstetricians and Gynecologists 6

Women may discontinue screening after age 65 only if they meet ALL of the following criteria: have had no abnormal/positive cytology tests within the 10-year period prior to age 70 years, have documentation that the 3 most recent Pap tests were technically satisfactory and interpreted as normal, and have evidence of adequate negative prior screening and no history of CIN2+ within the last 20 years, as recommended by the American Cancer Society 1, 2, 3, 4, 5, 7

Screening after age 65 is specifically recommended for women in good health who have not been previously screened, women for whom information about previous screening is unavailable, women for whom there is a low likelihood of past screening, women with a history of cervical cancer or in utero exposure to DES, and women who are immunocompromised, including HIV-positive women, as recommended by the American College of Obstetricians and Gynecologists 2, 3, 4, 5, 7, 8, 9

Education should address that HPV infection is common and usually not harmful, a positive HPV test result does not indicate the presence of cancer, and the majority of women who test positive for HPV will not develop advanced cervical neoplasia, as recommended by the American Cancer Society 2, 3, 4, 5, 7, 8

Discontinuing screening too early (before age 65) when a woman has not had adequate prior screening, over-screening, under-screening high-risk populations, and failing to document screening history adequately, which may lead to unnecessary continuation or inappropriate cessation of screening, as recommended by the American College of Obstetricians and Gynecologists 1, 6