Updated cervical cancer screening guidance

On April 23, 2026, the American College of Obstetricians & Gynecologists (ACOG) published updated cervical cancer screening guidance based on the 2026 update to the Women's Preventive Services Initiative’s (WPSI) updated cervical cancer screening recommendations for patients at average risk. These recommendations now include the option for average-risk patients aged 30–65 years to collect their own samples for hrHPV primary screening every three years. “Too many people in the United States are needlessly suffering from cervical cancer. Underscreening—and lack of screening—is the most significant contributor to the development of this largely preventable illness,” said ACOG President Steven J. Fleischman, MD, MBA, FACOG.

Per ACOG, the patient-collected sampling option should only be provided if patients prefer this method and if appropriate clinical infrastructure and oversight for notification, documentation, and referral for follow-up when indicated are in place. A summary of recommendations for cervical cancer screening for patients at average risk is as follows:

• Individuals aged 21–29 years should be screened for cervical cancer every three years with cervical cytology alone.
• Individuals aged 30–65 years should undergo clinician-collected primary high-risk human papillomavirus (hrHPV) screening every five years, using U.S. Food and Drug Administration–approved tests for primary screening.
• Co-testing with hrHPV and cervical cytology every five years for individuals aged 30–65 years is acceptable when primary hrHPV testing is not available or, after counseling, the patient chooses co-testing. Patient-collected primary hrHPV screening every three years, using U.S. Food and Drug Administration–approved testing kits, may be considered when systems are in place for appropriate notification and follow-up.
• Cervical cytology alone for individuals aged 30–65 years should be used only in settings in which primary hrHPV testing or co-testing is not available or if, after counseling, the patient chooses cervical cytology alone.
• Routine screening is not clinically indicated in patients older than age 65 years if they have received adequate prior screening, defined as three consecutive negative cytology results or two consecutive negative co-testing results within 10 years before stopping screening, with the most recent test occurring within 3 years for cytology alone or 5 years if co-testing is used. For patients older than age 65 years who have not received adequate prior screening according to the criteria described or who are at high-risk for cervical cancer, screening should continue.
• Routine cervical cancer screening is not recommended for patients who have undergone hysterectomy with removal of the cervix and who do not have a history of cervical cancer or another high-grade precancerous lesion.

“For labs, the ACOG updates are important because clinicians look to ACOG when making decisions about how to practice. And recently updated HRSA guidelines help in guiding health insurance coverage for cervical cancer screening. Both the ACOG and HRSA guidelines prefer that women aged 30-65 of average risk be screened with primary HPV testing. Both also highlight that patient-collected samples are an appropriate sample type for primary HPV testing in the same age group and should be offered for cervical cancer screening. This is supported by the evidence reported in the draft USPSTF guidelines, which showed a strong agreement for HPV testing results regardless of whether a patient or a clinician collected the sample,” said Samantha Byrnes, MPH, PhD, senior scientific partner for sexual health and cervical cancer, Roche Diagnostics. “It is encouraging to see changes that support a shift to HPV screening technologies that could have a positive impact to empower women, improve health outcomes, and move us closer to making cervical cancer a disease of the past.”