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MSDMerck ManualProfessional Version
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Cervical Cancer Screening

Age Group

ACS 2020 Recommendations*

USPSTF 2018 Recommendations*

Age 21‒24

No screening

Cervical cytology alone every 3 years

Age 25–29

One of the following:

  • HPV test† every 5 years (preferred)

  • HPV and Pap co-testing every 5 years (acceptable)

  • Pap test every 3 years (acceptable)

Cervical cytology alone every 3 years

Age 30‒65

One of the following:

  • HPV test every 5 years (preferred)

  • HPV/Pap co-testing every 5 years (acceptable)

  • Pap test every 3 years (acceptable)

One of the following:

  • Cervical cytology alone every 3 years

  • HPV testing alone every 5 years

  • HPV/cervical cytology cotesting every 5 years

Age > 65

Discontinuation of screening if adequate negative prior screening‡

For women without documentation of prior screening, continued screening until criteria for stopping are met

Discontinuation of screening if adequate negative prior screening† and not at high risk of cervical cancer

† A test FDA-approved for primary HPV testing should be used for primary screening.

‡ Adequate negative prior screening is currently defined as 2 consecutive negative primary HPV tests or 2 negative Pap/HPV cotests or 3 negative Pap (cytology) tests within the past 10 years, with the most recent test occurring within the past 3–5 years.

ACS = American Cancer Society; FDA = US Food and Drug Administration; HPV = human papillomavirus; hrHPV = high-risk HPV; Pap = Papanicolaou; USPSTF = US Preventive Task Force.

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