When should you get screened for cervical cancer?

Cervical cancer is almost always caused by persistent infection with high-risk strains of human papillomavirus (HPV). Routine screening has dramatically reduced cervical cancer deaths, as early detection makes precancer treatment more effective.

Dr. Kathy MacLaughlin, a Mayo Clinic family physician specializing in cervical cancer prevention, emphasizes the importance of regular screenings. "The U.S. Preventive Services Task Force recommends screening for individuals aged 21 to 65, either with a Pap smear every three years or, starting at age 30, the Pap/HPV co-test or primary HPV test every five years," she explains.

Beginning February 5, Mayo Clinic practices in the Midwest will introduce an FDA-approved self-collection HPV test to reduce barriers to screening, with plans to expand to Arizona and Florida. This new option aligns with updated guidelines, which recommend:

• Ages 21–29: Screening every three years with cervical cytology alone.
• Ages 30–65: Screening every three years with cytology alone, every five years with HPV testing, or every five years with HPV/cytology co-testing.

Dr. MacLaughlin adds that screening beyond age 65 may not be necessary if there’s a history of consistent negative results. Still, exceptions apply for individuals with specific risk factors, such as prior precancer treatment, immunocompromised status, or in utero DES exposure.

Risk Factors and Prevention

"Persistent high-risk HPV infection is the primary cause of cervical cancer," says Dr. MacLaughlin. Other factors include smoking, lack of screening, and multiple sexual partners. Preventative steps include:

1. HPV vaccination, recommended for ages 9–26 and available for ages 27–45 after consultation.
2. Regular screenings based on guidelines.
3. Prompt management of abnormal screening results.

What Happens with HPV Self-Collection Results?

Dr. MacLaughlin explains that most patients (85%–90%) will test negative and be advised to repeat testing in three years. Those with positive results will require follow-up testing, with specific actions depending on the type of HPV detected.

• HPV 16 and HPV 18, responsible for 70% of cervical cancers, necessitate a referral for colposcopy.
• Other high-risk HPV types require an additional Pap test to guide further steps.

The U.S. Preventive Services Task Force is reviewing draft recommendations to endorse HPV self-collection for ages 30–65, further supporting this convenient and effective screening option.

If you're unsure about your screening needs, consult your healthcare provider to develop a personalized prevention plan.

A version of this article was originally published in the Mayo Clinic News Network