Who this is for
Anyone with a cervix at average risk, which the bodies below define as not having HIV, not being immunocompromised, and not having had in-utero DES exposure, a high-grade precancerous lesion, or cervical cancer. Those groups are screened on a different schedule that none of the rows below covers.
Having had the HPV vaccine does not take you out of screening. As ACS puts it: "Getting the HPV vaccine greatly reduces your risk of cervical cancer, but it doesn't eliminate it completely."
All three bodies also agree that screening stops after a hysterectomy that removed the cervix, when there is no history of cervical cancer or a high-grade lesion.
Where the recommendations diverge
- USPSTF 21 to 29
- USPSTF 30 to 65
- ACS 25 and older
- ACOG 21 to 29
- ACOG 30 to 65
The USPSTF recommends screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years.
Our note: USPSTF lists this topic as being updated. Its draft comment period has closed and no replacement has been finalized, so the 2018 statement is still its current position.
For women aged 30 to 65 years, the USPSTF recommends screening every 3 years with cervical cytology alone, every 5 years with high-risk human papillomavirus (hrHPV) testing alone, or every 5 years with hrHPV testing in combination with cytology (cotesting).
Our note: The 2018 statement treats the three strategies as equivalent options. It names no preferred test, which is where the other two bodies have since moved.
Women and other individuals with a cervix at average risk for cervical cancer ... should start screening at age 25 and continue until at least age 65.
Our note: Ellipsis replaces the on-page cross-reference "(see below)". ACS sets no hard stop: "You can stop cervical cancer screening at age 65 if your most recent screening tests have been normal." Other options: self-collected HPV every 3 years, co-testing every 5, Pap alone every 3.
Individuals aged 21–29 years should be screened for cervical cancer every 3 years with cervical cytology alone.
Our note: Committee Statement 28. The page is dated July 2026 with no day given, so we record the first of that month. It replaces ACOG's 2021 practice advisory, now withdrawn.
Individuals aged 30–65 years should undergo clinician-collected primary high-risk human papillomavirus (hrHPV) screening every 5 years, using U.S. Food and Drug Administration–approved tests for primary screening.
Our note: Committee Statement 28, dated July 2026 with no day given, so we record the first of that month. Co-testing every 5 years is acceptable where primary hrHPV is unavailable or the patient chooses it. Patient-collected samples get a 3-year interval, because data for 5 years are lacking.
Why they differ
Two things separate these three, and only one of them is about age.
- When to start: 21 or 25. ACS starts at 25. USPSTF and ACOG start at 21. One of the three publishes a full evidence rationale for where it puts the floor, and it is the USPSTF. Under the heading "Women Younger Than 21 Years" it argues that screening before 21 does net harm: "Cervical cancer is rare before age 21 years ... Because of the slow progression of disease and the high likelihood of regression in this age group, evidence suggests that screening earlier than age 21 years, regardless of sexual history, would lead to more harm than benefit." It adds that treating CIN 2 or CIN 3 under 21 "may increase risk for adverse pregnancy outcomes", notes that "the decision analysis model commissioned for the 2012 USPSTF recommendation showed no net benefit to starting screening before age 21 years", and concludes "with moderate certainty that the harms of screening in women younger than 21 years outweigh the benefits".
- What is missing is the case for moving that floor to 25. ACOG is explicit about its basis for 21 to 29, and the basis is deference rather than its own reading of the evidence: under "Rationale and Implementation Considerations" it says its recommendations for this age group "remain unchanged and align with the WPSI screening recommendations", and it then records the disagreement without adjudicating it: "ACOG also recognizes that the American Cancer Society (ACS) includes primary hrHPV screening as an option for patients aged 25–29 years." On the ACS guideline page we cite, the age 25 appears exactly once, in the recommendation sentence itself, with no reason attached. So the argument for not screening before 21 is published in full, and the argument for waiting until 25 is not published where ACS states the recommendation. If your clinician follows ACS, that reasoning is a fair thing to ask about.
- Which test leads. USPSTF's 2018 statement lists cytology, hrHPV alone and co-testing as equivalent choices for ages 30 to 65. Both ACS and ACOG have since moved to naming primary HPV testing the preferred option, with cytology demoted to a fallback. This gap is largely a difference of date rather than of opinion: USPSTF has not reissued, and its own page says the topic is under update.
So read the effective dates in the ledger before you read the rows. They separate a live disagreement, the start age, from a stale one, the test.
3 documents set the numbers on this page. The oldest was published in 2018, the newest in 2026.
We last re-read these sources on . How we verify.
What the test involves
You lie back, a speculum holds the vaginal walls open, and a small brush or spatula collects cells from the cervix. It takes under a minute and is usually described as pressure rather than pain. A self-collected HPV test uses a soft swab inserted into the vagina instead; ACS notes it can be done privately in a clinic or at home, but a clinician still has to order it and only FDA-approved kits count.
If the result is abnormal
A positive HPV test is common and usually does not mean cancer or even precancer; most infections clear. What it means is closer follow-up, which depending on the result and your history can be a repeat test in a year, a Pap on the same sample, or colposcopy, where a magnifying scope examines the cervix and a small biopsy may be taken.
Precancerous changes found this way are treatable, which is the entire point of screening for this cancer rather than waiting for symptoms.
More on this screening
Frequently asked questions
Should I start at 21 or 25?
ACS says 25. USPSTF and ACOG both say 21. ACOG restated 21 as recently as July 2026, so this is a live disagreement rather than one body being out of date. In practice your clinician follows one of the two, and either is defensible under current US guidance.
Do I still need a Pap test if I get an HPV test?
Not necessarily. For ages 30 to 65, both ACS and ACOG now prefer a primary HPV test on its own, every 5 years. Co-testing, which runs both on the same sample, is an accepted alternative. Pap alone every 3 years is still an option, but both bodies now treat it as the fallback rather than the default.
Can I collect the sample myself?
Yes, with conditions. ACS lists self-collected HPV testing every 3 years as an option, and ACOG says patient-collected primary hrHPV screening may be considered when there are systems in place for notification and follow-up. Both insist on an FDA-approved kit ordered or approved by a clinician. ACOG specifically recommends a 3-year interval rather than 5 for self-collected samples, because the evidence for a 5-year gap is not there yet.
When can I stop?
At 65, if you have been screened regularly and the recent results were normal. ACS spells out what regularly means: two consecutive normal HPV or co-tests, or three normal Pap tests. ACOG uses the same idea, defining adequate prior screening as three consecutive negative cytology results or two consecutive negative co-tests within the previous 10 years. If you cannot show that, both say keep screening past 65.