Cervical cancer screening guideline updated: What to know

ACS cervical cancer screening guideline updates: What to know

Cervical cancer remains a major global health concern. According to the World Health Organization (WHO), cervical cancer was the fourth most common cancer among women in 2022, with an estimated 660,000 new cases. Studies also project that cervical cancer cases may rise by nearly 57% by 2050.

The American Cancer Society (ACS) has released updated cervical cancer screening guidelines, announcing key changes such as a revised starting age for screening, the introduction of FDA-approved self-collected HPV testing, and clearer recommendations for when to stop screening. These updates were published in CA: A Cancer Journal for Clinicians, the flagship journal of the ACS.

Self-collected HPV testing: What it means

While ACS continues to recommend HPV testing using a cervical sample collected by a healthcare provider every five years, the new guidelines now allow women to collect their own sample using an FDA-approved self-collection kit.

Blair R. Gumnic, DO, an obstetrician/gynecologist at Hackensack Meridian Jersey Shore University Medical Center, said that a self-collected HPV test can be done at home or in a clinic and screens for high-risk HPV variants that may cause cervical cancer. A positive result, however, still requires follow-up with a doctor because a Pap smear—performed only by a medical provider—detects both HPV and cellular changes.

Jason Knight, MD, a board-certified gynecologic oncologist and regional director of gynecologic oncology at Atlantic Health, added that self-collection requires a prescription and involves collecting a vaginal sample using a swab or brush, which is then sent to a lab.

Pros and cons of self-collected HPV testing

Ami P. Vaidya, MD, co-vice chair of obstetrics and gynecology at Hackensack University Medical Center, believes the option improves access to care, especially for women with limited healthcare access.

However, G. Thomas Ruiz, MD, lead OB/GYN at MemorialCare Orange Coast Medical Center, expressed concern about potential user error and emphasized the need for long-term data to evaluate effectiveness.

Screening begins at age 25

ACS now recommends cervical cancer screening from age 25 to 65 for individuals at average risk.

Knight explained that HPV testing alone is now considered the preferred screening method. Provider-collected HPV testing (alone or with a Pap test) is recommended every five years. Self-collected HPV testing or a provider-collected Pap test alone should be done every three years.

The best method, he added, should be determined in consultation with a healthcare provider.

Updated guidance on when to stop screening

The guidelines advise stopping cervical cancer screening after age 65 if the individual has been regularly screened for many years and their most recent two or three tests (depending on HPV inclusion) were normal.

Gumnic noted that the updated criteria clearly define what constitutes adequate prior screening—a detail missing in earlier guidelines.

Pap smear is only one part of cancer prevention

Experts emphasized that Pap smears are just one component of overall women's health.

Vaidya highlighted the importance of HPV vaccination and consistent screening adherence. Gumnic encouraged patients to stay informed about new guidelines. Ruiz stressed that annual wellness visits, including pelvic exams and STI testing, remain essential even if a Pap smear is not due.

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