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Note: In January 2026, the US Health Resources and Services Administration (HRSA) approved updated guidelines from the Women's Preventive Services Initiative (WPSI) that designate high-risk human papillomavirus (HPV) testing as the preferred screening modality for women at average risk who are 30 to 65 years years of age. As a result, private insurance companies are required to cover this preventive service without cost-sharing by January 1, 2027. Supporting evidence and implementation considerations can be seen in the WPSI guidelines.

Am Fam Physician. 2026;113(2):137-144

Patient information: A handout on self-collected samples for cervical cancer screening is available with the online version of this article.

This clinical content conforms to AAFP criteria for CME.

Author disclosure: No relevant financial relationships.

Globally, cervical cancer is the fourth most common cancer in women and other people with a cervix. Population-based screening, applied to asymptomatic average-risk individuals, remains the core of prevention and focuses on the risk of high-grade cervical precancers and cancers. In the United States, underscreening is associated with socioeconomic disparities. Screening strategies include cytology alone, cotesting, and primary human papillomavirus (HPV) screening. The American Cancer Society recommends initiating cervical cancer screening at 25 years of age; primary HPV testing every 5 years is the preferred method. The US Preventive Services Task Force 2024 draft recommendation endorses the use of primary HPV screening every 5 years as the preferred method beginning at 30 years of age and recommends cytology alone every 3 years in patients 21 to 29 years of age. Cytology alone and cotesting are acceptable screening methods. Conclusion of screening at 65 years of age is recommended for individuals without a history of high-grade cervical intraepithelial neoplasia or cervical cancer in the past 25 years and with adequate negative screening results at 60 and 65 years of age. Management of patients with abnormal cervical cancer screening results should follow the 2019 American Society for Colposcopy and Cervical Pathology (ASCCP) risk-based management consensus guidelines.

Globally, cervical cancer is the fourth most common cancer in women and other people with a cervix, with an estimated 660,000 new cases diagnosed in 2022.1 Ineffective screening programs are associated with higher cervical cancer incidence and mortality.2,3 The American Cancer Society (ACS) projected that in 2025, there would be 13,360 new cervical cancer diagnoses and 4,320 deaths.4 In the United States, cervical cancer incidence and related deaths decreased by more than 50% from the mid-1970s to the mid-2000s, largely due to screening.4

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