Updated Cervical Cancer Screening Guidelines: What Women Need to Realize

At the end of 2025, the American Cancer Society (ACS) released its new cervical cancer screening guidelines. Shortly after, in January 2026, the Health Resources and Services Administration (HRSA) endorsed a new set of guidelines as well. While largely in agreement, some key differences exist between the two.

Where the Guidelines on HPV Screening Agree

Both the ACS and HRSA prioritize the HPV primary test for cervical cancer screening in individuals aged 30-65. This test identifies the types of HPV (human papillomavirus) responsible for approximately 70% of cervical cancers . If the HPV primary test isn’t available, both organizations recommend co-testing, which combines an HPV test with a Pap test (also known as cytology). If neither of these options are available, a Pap test alone is acceptable.

A significant shift in recommendations is the acceptance of self-collected HPV tests. Traditionally, samples for both HPV and Pap tests were collected by healthcare providers during a speculum exam. The ACS acknowledges this can be a barrier for some, and self-collection is now considered an acceptable alternative. HRSA also supports screening with self-collection .

Following normal results, screening intervals are generally three or five years. Those receiving HPV primary testing or co-testing with provider-collected samples and normal results should be rescreened in five years. The ACS specifies a three-year interval for individuals who self-collect their HPV test and receive normal results – a distinction not included in the HRSA guidelines. Individuals receiving only a Pap test with normal results should be rescreened every three years. Abnormal results will likely necessitate more frequent screening.

Screening can generally end at age 65 if previous test results were normal. The ACS recommends cessation at 65 after a decade of normal results (negative HPV tests at 60 and 65, or three consecutive negative Pap tests, with the last at age 65). HRSA guidelines also suggest ending screening at 65, but are less specific regarding prior results .

Where the Guidelines Differ

The ACS suggests initiating screening at age 25, regardless of the test type. HRSA, though, recommends Pap tests every three years between ages 21 and 29, transitioning to HPV primary testing or co-testing at age 30.

What This Means for Patients

The specific screening test a patient receives will largely depend on what their healthcare provider offers. With both sets of guidelines favoring HPV primary testing, a shift towards this method is anticipated in the coming years.

HRSA’s guidelines also influence insurance coverage. Most private insurance companies are required to cover recommended testing options and follow-up testing without copays, starting in 2027.

The availability of self-collected HPV tests has the potential to expand cervical cancer screening access beyond traditional gynecological settings. Screening may become available at primary care offices, urgent care clinics, mobile clinics, and even some pharmacies, or through at-home self-collection. This can benefit individuals lacking access to a gynecologist or those uncomfortable with vaginal exams.

Regular cervical cancer screening remains crucial for all individuals with a cervix. Anyone with questions about screening needs or the best test option should consult with a healthcare provider.