Practice Guidelines

ACP Releases Best Practice Advice on Screening for Cervical Cancer


Am Fam Physician. 2015 Dec 15;92(12):1107-1110.

Key Points for Practice

• Cytology without HPV testing should be performed every three years starting at 21 years of age to screen for cervical cancer.

• Cytology with HPV testing may be performed starting at 30 years of age to increase screening intervals to every five years.

• Screening should stop after 65 years of age in the setting of three consecutive negative cytology results or two consecutive negative cytology plus HPV cotesting results, with the most recent test performed within the previous five years.

From the AFP Editors

Screening for cervical cancer has likely contributed to decreased incidence and mortality rates of the disease over the past several decades. However, the medical cost of screening is substantial. New evidence-based guidelines aim to minimize the harms of overscreening while maximizing benefit. Based on the best available evidence, the American College of Physicians (ACP) has released best practice advice on cervical cancer screening in average-risk, asymptomatic women 21 years or older. This advice is targeted to all clinicians, and refers to screening for cervical precancerous and cancerous lesions detected on cytology and other tests for high-risk types of human papilloma-virus (HPV). This advice is supported by the American Congress of Obstetricians and Gynecologists and endorsed by the American Society for Clinical Pathology.

Best Practice Advice

ACP's best practice advice focuses on increasing the age at which to begin screening, i

Coverage of guidelines from other organizations does not imply endorsement by AFP or the AAFP.

This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.

A collection of Practice Guidelines published in AFP is available at


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