New Cervical Cancer Screening Guidelines: ACS & HRSA Updates (2026)
New guidelines for cervical cancer screening were released at the end of 2025 by the American Cancer Society (ACS), and endorsed in January 2026 by the Health Resources and Services Administration (HRSA), part of the Health and Human Services Department (HHS). While the two sets of guidelines largely align, some differences exist regarding when screening should begin and how often it should occur.
Understanding the Updated Recommendations
The Shift Towards 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 identifies types of human papillomavirus (HPV) responsible for approximately 70% of cervical cancers. If this test isn’t available, co-testing – an HPV test combined with a Pap test – is recommended. A Pap test alone remains an option if neither of the previous tests are accessible.
Increased Flexibility with Sample Collection
Traditionally, healthcare providers collected samples for both HPV and Pap tests during a speculum exam. Recognizing potential barriers to this method, both organizations now accept self-collected HPV tests as a viable alternative, particularly when access to a provider or comfort with the traditional exam is limited.
Varying Follow-Up Schedules
The frequency of follow-up screenings depends on the type of test used and how the sample was collected. Individuals with normal results from HPV primary testing or co-testing with provider-collected samples should be rescreened in five years. The ACS specifies that those who self-collect their HPV samples and receive normal results should be screened again in three years – a distinction not made in the HRSA guidelines. Those receiving only a Pap test with normal results should return for screening in three years. Abnormal results will likely necessitate more frequent testing.
Key Differences in the Guidelines
Age to Begin Screening
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 ages 21 and 29, transitioning to HPV primary testing or co-testing at age 30.
Implications for Patients and Providers
For most patients, the specific screening test offered will depend on their healthcare provider’s capabilities. The preference for HPV primary testing by both organizations could lead to increased adoption of this method in the coming years.
HRSA’s guidelines are also expected to influence insurance coverage, with most private insurance companies required to cover recommended testing options and follow-up care without copays starting in 2027. The acceptance of self-collected HPV tests could expand screening access beyond traditional gynecological settings, potentially including primary care offices, urgent care clinics, mobile clinics, and even some pharmacies, offering a more convenient option for those without easy access to a gynecologist or who prefer at-home sample collection.
Frequently Asked Questions
When should I start getting screened for cervical cancer?
The ACS recommends starting at age 25, while HRSA recommends starting Pap tests at age 21 and switching to HPV primary testing or co-testing at age 30.
What is HPV primary testing?
HPV primary testing looks for the types of HPV that are known to cause about 70% of cervical cancers and is recommended for individuals between 30 and 65.
Can I collect my own sample for an HPV test?
Yes, both the ACS and HRSA accept self-collected HPV tests as an alternative to samples collected by a healthcare provider during a speculum exam.
Ultimately, regular cervical cancer screening remains the most effective way to protect your health. If you have any questions about your individual screening needs, it’s important to discuss them with your healthcare provider.