New Cervical Cancer Screening Guidelines 2026: ACS & HRSA Updates
New guidelines for cervical cancer screening were released at the close of 2025 by the American Cancer Society (ACS), with endorsement following in January 2026 from the Health Resources and Services Administration (HRSA), an agency within the Department of Health and Human Services (HHS). While largely in agreement, the two sets of recommendations present some key distinctions for patients and healthcare providers.
Understanding the Updated Recommendations
The Shift to HPV Primary Testing
Both the ACS and HRSA now prioritize the use of an HPV primary test for individuals between the ages of 30 and 65 who are at average risk. This test specifically identifies types of the human papillomavirus (HPV) responsible for approximately 70% of cervical cancers. If the HPV primary test is unavailable, both organizations recommend “co-testing,” which combines an HPV test with a traditional Pap test, also known as cytology. A Pap test alone remains an option if neither of the other tests are accessible.
Increased Flexibility with Sample Collection
Traditionally, samples for both HPV and Pap tests have been collected by healthcare providers during a speculum exam. recognising potential barriers to this method, the ACS acknowledges that self-collected HPV tests are an acceptable alternative in certain situations. HRSA also supports screening with self-collection.
Varying Follow-Up Schedules
The frequency of future screenings depends on the type of test administered and how the sample was collected. Individuals receiving HPV primary testing or co-testing with provider-collected samples and achieving normal results should be rescreened in five years. The ACS specifies that those using self-collected HPV tests with normal results should return for screening in three years – a distinction not included in the HRSA guidelines. Those receiving only a Pap test with normal results should be screened again in three years. Abnormal results will likely necessitate more frequent screenings.
Key Differences in the Guidelines
Age of Screening Initiation
The ACS suggests initiating screening at age 25, citing the rarity of cervical cancer in younger individuals. HRSA, however, recommends Pap tests every three years between the ages of 21 and 29, transitioning to HPV primary testing or co-testing at age 30.
Implications for Patients and Insurance
For most patients, the specific screening test offered will depend on their healthcare provider’s practices. The preference for HPV primary testing by both organizations may lead to wider adoption of this method in the coming years. HRSA’s guidelines also have implications for insurance coverage, as most private insurance companies are required to cover recommended testing options and follow-up care without copays, beginning with policies in 2027.
The availability of self-collected HPV tests could expand screening access beyond traditional gynecological settings. Screening may become available at primary care offices, urgent care clinics, mobile clinics, and even some pharmacies, or through at-home sample collection. This could be particularly beneficial for individuals lacking access to a gynecologist or who experience discomfort with vaginal exams.
Frequently Asked Questions
At what age does the ACS recommend starting cervical cancer screening?
The ACS recommends people start screening at age 25 regardless of what test they are getting.
What does HRSA recommend for screening between ages 21 and 29?
HRSA recommends people get Pap tests every three years between ages 21 and 29 and start HPV primary testing or co-testing at age 30.
Can I collect my own sample for an HPV test?
Yes, both the ACS and HRSA recognize self-collected HPV tests as an acceptable alternative to provider-collected samples, particularly when access to traditional screening is limited.
regular cervical cancer screening remains the most effective way to protect your health. If you have any questions about whether or when you should be screened, or which test is best for you, it’s important to discuss your individual needs with a healthcare provider.