Berlin – New guidelines from the American Cancer Society (ACS) are aiming to simplify and broaden access to cervical cancer screening, with a significant emphasis on primary HPV testing and the acceptance of self-collected samples. These updated recommendations, released in early February 2026, represent a shift in approach designed to improve screening rates and ultimately reduce the incidence of this preventable cancer. Cervical cancer screening remains a cornerstone of women’s health, and these changes reflect evolving scientific understanding and a commitment to equitable access to care.
For decades, the Pap test has been the standard for cervical cancer screening, identifying precancerous cell changes. However, current understanding of the disease points to the human papillomavirus (HPV) as the primary cause of nearly all cervical cancers. The ACS recommendations now prioritize testing for high-risk HPV types, recognizing that identifying the presence of the virus is a more direct indicator of cancer risk. This shift is not merely a technical adjustment; it has the potential to significantly improve the effectiveness of screening programs and reduce unnecessary follow-up procedures. Approximately 14,000 cases of cervical cancer are diagnosed in the United States annually, and more than 4,000 women die from the disease each year, according to the Centers for Disease Control and Prevention (CDC).
Understanding the New Recommendations for Cervical Cancer Screening
The ACS recommendations cover several key areas, including the age to begin screening, the preferred testing method, and the frequency of follow-up. A central tenet of the new guidelines is the recommendation for “HPV primary screening,” where available. This involves testing for the presence of high-risk HPV types that are known to cause cervical cancer. If HPV primary testing isn’t accessible, the ACS suggests “co-testing,” which combines an HPV test with a Pap test. In situations where neither of these options is available, a Pap test alone remains an acceptable alternative. The choice of testing method, and how the sample is collected, will influence how often a person needs to be screened.
One of the most notable changes is the recommended starting age for screening, now set at 25. This represents a departure from previous guidelines, and from current recommendations by the United States Preventive Services Task Force (USPSTF), which suggest starting Pap tests at age 21 and transitioning to HPV primary testing or co-testing at age 30. The ACS lowered the starting age based on evidence suggesting that cervical cancer is rare in individuals under 25, and that earlier screening may lead to unnecessary interventions.
The Rise of Self-Collected Samples
Perhaps the most significant change impacting accessibility is the ACS’s acceptance of self-collected HPV tests. Traditionally, samples for both Pap and HPV tests were collected by a healthcare provider during a pelvic exam. Even as provider-collected samples remain the preferred method, the ACS acknowledges that this can be a barrier for many individuals, whether due to discomfort, lack of access to healthcare, or logistical challenges. Self-collection allows individuals to collect their own vaginal samples, either at home with a kit or under the supervision of a healthcare provider, eliminating the need for a speculum exam. This is particularly important for individuals in rural areas, those with limited access to gynecological care, or those who have experienced trauma or discomfort with traditional pelvic exams.
The American Society for Colposcopy and Cervical Pathology (ASCCP) has too issued guidance supporting self-collection for cervical cancer screening, noting that it can help to increase screening rates among underserved populations. The frequency of follow-up screening depends on the test used and how the sample was collected. Individuals who undergo HPV primary testing or co-testing with provider-collected samples and receive normal results should be screened again in five years. Those who self-collect samples for HPV testing and have normal results should be screened every three years. Individuals who only receive a Pap test and have normal results should also be screened every three years. Any abnormal results will necessitate more frequent monitoring.
When Can Screening Be Stopped?
The ACS recommends that individuals can discontinue cervical cancer screening at age 65 if they have had a decade of consistently normal results. In other words either negative HPV tests at ages 60 and 65, or three consecutive negative Pap tests, with the most recent one occurring at age 65. This guidance reflects the understanding that the risk of developing cervical cancer significantly decreases with age, particularly for individuals with a history of consistent normal screening results. However, individuals with a history of precancerous lesions or cervical cancer should continue to follow their healthcare provider’s recommendations for ongoing screening.
The USPSTF is currently in the process of updating its own cervical cancer screening guidelines, and their recommendations carry significant weight as they influence what health insurance plans will cover. The USPSTF currently recommends screening every 3 years with cervical cytology alone for women ages 21 to 29, and then every 5 years with high-risk HPV primary screening or co-testing for women ages 30 to 65. Any divergence between the ACS and USPSTF guidelines could create confusion for both patients and healthcare providers, highlighting the importance of clear communication and shared decision-making.
The Impact of Widespread Screening
The success of widespread cervical cancer screening programs in the United States is undeniable. Since the mid-1970s, the incidence of cervical cancer has been reduced by more than half, largely due to increased screening rates. However, disparities persist, with over half of cervical cancer diagnoses occurring in individuals who have never been screened or who are screened infrequently. These disparities often disproportionately affect marginalized communities, underscoring the need for targeted outreach and interventions to improve access to screening services.
The introduction of self-collection options is expected to play a crucial role in addressing these disparities. By removing barriers to access, self-collection can empower individuals to accept control of their health and participate in life-saving screening programs. Testing can now potentially be done at a primary care provider’s office, an urgent care clinic, a mobile clinic, or even some pharmacies, in addition to the option of at-home collection. As Dr. Robert Smith, senior vice president of early cancer detection science at the American Cancer Society, explained, the development of self-collection tools will “broaden access to screening” and ultimately help to improve compliance and reduce the risk of cervical cancer.
Key Takeaways:
- The ACS now recommends starting cervical cancer screening at age 25.
- HPV primary testing is the preferred method, but co-testing or Pap tests are acceptable alternatives.
- Self-collected samples are now an approved option for HPV testing.
- Screening can generally be stopped at age 65 with a decade of normal results.
The updated ACS guidelines represent a significant step forward in cervical cancer prevention. By prioritizing HPV testing, embracing self-collection, and clarifying screening recommendations, these changes aim to make screening more accessible, effective, and equitable for all individuals with a cervix. The USPSTF is expected to release its updated recommendations later in 2026, which will further shape the landscape of cervical cancer screening in the United States. Individuals are encouraged to discuss these new guidelines with their healthcare providers to determine the most appropriate screening plan for their individual needs and risk factors.
Stay informed about the latest developments in cervical cancer screening and prevention by visiting the American Cancer Society website and consulting with your healthcare provider. Share this information with your network to help raise awareness and encourage regular screening.
Related reading