Cervical cancer screening is undergoing a significant shift, with new guidelines released at the end of 2025 by the American Cancer Society (ACS) and endorsed in January 2026 by the Health Resources and Services Administration (HRSA). These updated recommendations prioritize HPV primary testing and, notably, expand options for self-collection of samples, potentially increasing access to vital preventative care. The USF researcher addresses a growing crisis: health care worker burnout, which can impact access to care.
The changes aim to make cervical cancer screening more accessible and convenient, particularly for individuals who face barriers to traditional healthcare settings. Research into the leverage of artificial intelligence in healthcare, even as not directly related to screening guidelines, highlights the broader trend of leveraging innovation to improve patient care.
HPV Primary Testing and Co-Testing
Both the ACS and HRSA now recommend HPV primary testing as the preferred method for cervical cancer screening for individuals aged 30-65. This test specifically looks for high-risk types of human papillomavirus (HPV) known to cause approximately 70% of cervical cancers. If HPV primary testing isn’t available, co-testing – combining an HPV test with a Pap test (also known as cytology) – is recommended. If neither of these options are available, a Pap test alone can be used. This shift reflects growing evidence supporting the effectiveness of HPV testing in identifying precancerous changes.
The Rise of Self-Collection
A key change in the updated guidelines is the acceptance of self-collected HPV tests. Traditionally, samples for both HPV and Pap tests were collected by healthcare providers during a pelvic exam. While the ACS still prefers provider collection, it acknowledges that this can be demanding or uncomfortable for some individuals. HRSA also explicitly endorses self-collection as an acceptable alternative. This is a significant step towards removing barriers to screening, particularly for those who lack access to gynecological care or experience anxiety related to pelvic exams.
Screening Frequency and When to Stop
The frequency of screening depends on the type of test used and how the sample was collected. Individuals receiving HPV primary testing or co-testing with provider-collected samples and normal results should be screened again in five years. However, the ACS specifies that those who self-collect their HPV samples and receive normal results should be screened every three years – a distinction not included in the HRSA guidelines. Those who only receive a Pap test and have normal results should be screened again in three years. Individuals with abnormal results will likely require more frequent monitoring.
Both organizations agree that screening can generally end at age 65 if previous test results have been consistently normal. The ACS specifies a decade of normal results – negative HPV tests at ages 60 and 65, or three consecutive negative Pap tests with the last one at age 65. HRSA’s guidelines are less specific regarding past results, simply recommending cessation at age 65 with normal results.
Differences in Starting Age
There is some divergence in recommendations regarding the age to begin screening. The ACS suggests starting at age 25, citing the rarity of cervical cancer in younger individuals. HRSA, however, 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 test a patient receives will largely depend on what their healthcare provider offers. With both sets of guidelines favoring HPV primary testing, a gradual shift towards this method is anticipated. HRSA’s guidelines also carry weight with insurance companies, with most private insurers required to cover recommended testing options and follow-up care without copays starting in 2027. Issues affecting women’s care and access are complex and multifaceted, and these guidelines aim to address some of those challenges.
The expansion of HPV screening with self-collection has the potential to move screening beyond traditional gynecological offices. Patients may be able to be screened at primary care providers, urgent care clinics, mobile clinics, or even pharmacies, or collect samples at home. This increased accessibility is particularly beneficial for those without access to a gynecologist or who feel uncomfortable with pelvic exams.
Regular cervical cancer screening remains the most important step in prevention. Anyone with questions about their screening needs should consult with a healthcare provider.
Disclaimer: This information is intended for general knowledge and informational purposes only, and does not constitute medical advice. It’s essential to consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
The evolving landscape of cervical cancer screening promises to improve access and outcomes. Continued monitoring of the implementation of these new guidelines and their impact on screening rates will be crucial in the coming years. Share your thoughts and experiences in the comments below.
