The short version
- Screening starts at age 21. Nothing before that, no matter when you became sexually active. [1]
- For most women aged 21 to 29, that means a Pap test every three years. [1]
- From 30 to 65, ACOG's 2026 guidance says the preferred approach is a high-risk HPV test collected by your clinician, on its own, every five years. [2]
- Screening can usually stop after 65 if you have had enough normal results and no history of significant abnormality. If you have not had enough prior screening, or you are at high risk for cervical cancer, screening continues past 65. [2]
- Being vaccinated against HPV does not change your screening schedule. You still screen. [1]
This page is about average risk
Women with a history of cervical cancer or significant precancer, women with HIV, women whose immune systems are suppressed, and women exposed to DES before birth may need more frequent screening and should not follow the routine schedule. [1] If any of those describe you, your schedule is set individually.
Why screening works here
Cervical cancer takes years to develop from a persistent HPV infection. That slow timeline is what makes a test every three to five years enough. We are not trying to catch a cancer in the month it appears. We are trying to catch a change years before it becomes one, when removing a small piece of tissue ends the problem.
The current schedule
| What ACOG's 2026 committee statement says | What ACOG's patient FAQ (2021) says | |
|---|---|---|
| Under 21 | No screening. [2] | No screening. Start at 21 regardless of when you first had sex. [1] |
| 21 to 29 | Cervical cytology (Pap) alone every 3 years. [2] | Pap test alone every 3 years. HPV testing alone is acceptable from 25 to 29. [1] |
| 30 to 65 | Clinician-collected primary high-risk HPV testing every 5 years is preferred. If that is not available: co-testing every 5 years, or a patient-collected high-risk HPV test every 3 years. If neither of those is available: Pap alone every 3 years. [2] | Three options: co-testing every 5 years, Pap alone every 3 years, or HPV alone every 5 years. [1] |
| Self-collected sample | An option within the 30 to 65 schedule when clinician-collected testing is not available, every 3 years. The kit must be FDA approved and ordered or approved by a clinician, and ACOG says collection should happen only within a clinician-guided process with real notification and follow-up in place. [2] | Not addressed. [1] |
| Over 65 | Routine screening is not indicated if you have had adequate prior screening, meaning three negative Pap results in a row or two negative co-tests in a row within the previous 10 years, the most recent within 3 years for Pap alone or 5 years for co-testing. Without that, or if you are at high risk for cervical cancer, screening continues. [2] | Stop after 65 with no history of moderate or severe abnormality and adequate negative results in the past 10 years. [1] |
What changed in 2026
ACOG updated its cervical cancer screening guidance in 2026. The main change for women aged 30 to 65 is that a high-risk HPV test on its own, every five years, is now the preferred approach rather than one option among three. [2] Co-testing, which pairs an HPV test with a Pap, is still acceptable where primary HPV testing is not offered. [2]
The second change is self-collection. ACOG now says a patient-collected high-risk HPV sample every three years is an option when clinician-collected testing is not available. [2] Two conditions come with it. The kit has to be FDA approved and ordered or approved by a clinician, so a test bought directly off the internet is not what this means. And ACOG says collection should happen only inside a clinician-guided process, with real systems for documenting results, notifying women, and following up on abnormal ones, because without those the risk is a missed diagnosis that then goes unnoticed for another three to five years. [2] That option exists to reach women who are not getting screened at all, and reaching them matters: a joint consensus statement from SGO, ACOG, ASCCP, ASTRO, and the American Brachytherapy Society lays out how much of the remaining burden of cervical cancer in this country falls on women who face barriers to care. [3]
You may see two different schedules
ACOG's patient-facing FAQ page still carries its 2021 version, while the clinical committee statement was updated in 2026. Both are shown above on purpose. If your own doctor is following the older schedule, that is not a mistake, and it is a reasonable thing to ask them about at your next visit.
What your result means
- Negative HPV test. The virus that causes nearly all cervical cancer was not found. This is the most reassuring result there is, and it is why the interval can be five years.
- Positive HPV, normal Pap. Common, and usually not alarming. It typically means a repeat test in a year, or a specific HPV genotype check, depending on which type was found.
- Abnormal Pap. The next step is usually colposcopy, an office exam of the cervix with a magnifying scope and small biopsies. An abnormal Pap is not a cancer diagnosis. Most abnormal results are not cancer.
- Significant precancer on biopsy. This is usually treated, often with a cone biopsy, which removes the abnormal area and is frequently the end of the story.
Screening after a hysterectomy
It depends entirely on why the uterus was removed and whether the cervix came out with it. If your hysterectomy was for a benign reason and the cervix was removed, routine screening usually stops. If it was for cancer or significant precancer, or if the cervix is still there, screening continues on a schedule set for you. If nobody has told you which situation you are in, that is a good question for your next visit.
Cervical screening schedule card
A wallet-sized printable card with the current schedule and your next due date. This printable guide is in development. In the meantime, everything it will contain is on this page, and the office can walk you through it. See the handouts we do have.
Sources
- American College of Obstetricians and Gynecologists. Cervical Cancer Screening (patient FAQ). Copyright May 2021, accessed August 21, 2026. https://www.acog.org/womens-health/faqs/cervical-cancer-screening
- Screening for cervical cancer. Committee Statement No. 28. American College of Obstetricians and Gynecologists. Obstet Gynecol 2026;148:e63-e67. Published online April 15, 2026. https://www.acog.org/clinical/clinical-guidance/committee-statement/articles/2026/07/screening-for-cervical-cancer
- Neibart S, Zhou N, Chino J, et al. Health equity, disparities, and barriers to cervical cancer care in the U.S.: A consensus statement by SGO, ACOG, ASCCP, ASTRO, and ABS. Gynecol Oncol. 2025;200:186-192. Retrieved from PubMed (PMID 40947174). https://doi.org/10.1016/j.ygyno.2025.07.029
- National Cancer Institute. Cervical Cancer Treatment (PDQ) Patient Version. Updated April 3, 2025. https://www.cancer.gov/types/cervical/patient/cervical-treatment-pdq
Reviewed by DeEtte R. Vasques, DO, MBA · September 2026