Cervical Cancer Screening Guidelines

Screening Recommendations

The American College of Obstetricians and Gynecologists recommends screening with cytology alone every 3 years for women aged 21-29 years 2, 4, 5
The American Cancer Society recommends primary HPV testing every 5 years as the preferred method for women aged 30-65 years, with co-testing every 5 years as an acceptable alternative 1, 2, 6
The American College of Obstetricians and Gynecologists recommends against annual screening for any age group 4, 5
Women who have had a total hysterectomy with cervix removal and no history of cervical cancer or precancerous lesions in the past 25 years should not be screened 1
Women with a history of CIN2, CIN3, or adenocarcinoma in situ should continue routine screening for at least 20 years after spontaneous regression or appropriate management, even if this extends screening past age 65 years 2

Women who are HIV-positive, immunocompromised, or have a history of cervical cancer require different screening guidelines 2, 5
HPV-vaccinated women should follow the same screening recommendations as unvaccinated women 1, 2, 3

Screening can be discontinued in women over 65 years with adequate prior screening, defined as 2 consecutive negative primary HPV tests, 2 consecutive negative co-tests, or 3 consecutive negative cytology tests within the past 10 years, with the most recent test within the last 5 years 1, 2, 5