Cervical Cancer Screening

The Basics

What is cervical cancer screening?

Nearly all cervical cancer is caused by long-lasting infection with certain high-risk types of HPV (human papillomavirus), a very common virus. Screening looks for that virus and for early cell changes on the cervix, so anything abnormal can be followed or treated well before it would ever become cancer.

Which tests are used?

There are two, often used together: the Pap test (also called cytology) checks a sample of cervical cells for abnormal changes, and the HPV test checks the same kind of sample for high-risk HPV.

Who is it for?

Screening is for people with a cervix, which is most people assigned female at birth, and it’s still recommended even if you’ve had the HPV vaccine. Recommendations are based on your anatomy and history, so we individualize for transgender and gender-diverse patients.

Who & When

Guidelines were updated in 2025 to make HPV testing (including a sample you collect yourself) the preferred approach for people 30 and older. For those at average risk:

• Under 21 — no screening.
• 21 to 29 — a Pap test every 3 years.
• 30 to 65 — a primary HPV test every 5 years is now preferred (and can be a self-collected sample). Alternatives are a Pap every 3 years, or a Pap plus HPV co-test every 5 years.
• Over 65 — you can usually stop after enough prior normal results, if you’re not otherwise high risk.
• After a hysterectomy that removed the cervix for non-cancer reasons — screening generally isn’t needed.

The American Cancer Society goes a step further, suggesting primary HPV testing can start at age 25. We’ll help you decide what fits.

The Pap & HPV Tests

For a clinician-collected sample, a speculum is used to see the cervix and a small brush gathers cells. It takes a minute or two and usually feels like mild pressure. The same sample can be run for cytology (Pap), HPV, or both.

What about self-collection?

A newer, well-studied option lets you collect a vaginal swab yourself for HPV testing, which is nearly as accurate as a clinician-collected sample for detecting high-risk HPV. It can make screening far more comfortable and accessible. We offer a self-swab option; ask us if it’s right for you.

Your Results

Most results are normal, and you simply continue on schedule. If something comes back positive or abnormal, it rarely means cancer, it usually means we watch more closely or take a better look:

• HPV positive — may lead to a repeat test, a Pap on the same sample, or a closer exam called colposcopy.
• Abnormal Pap (such as ASC-US, LSIL, or HSIL) — ranges from very minor changes that often clear on their own to changes worth treating.
• Colposcopy — a magnified look at the cervix, sometimes with a small biopsy, to decide whether anything needs treatment.

The whole point of screening is to catch these changes at a stage when they’re easy to manage.

The HPV Vaccine

The HPV vaccine prevents the infections that cause most cervical cancer and several other cancers. It’s routine through age 26 and available case-by-case up to 45. Vaccination and screening work together, so keep screening even if you’re vaccinated. See our immunizations page for details.

Higher Risk

Some situations call for more frequent screening or closer follow-up, including a weakened immune system (such as HIV or a transplant), a previous high-grade cervical lesion or cervical cancer, or exposure to a medication called DES before birth. Let us know your history and we’ll tailor the timing.

Signs to Watch

Screening is for people without symptoms, but don’t wait for your next test if you notice:

• Bleeding between periods, after sex, or after menopause
• Unusual or persistent vaginal discharge
• Pelvic pain or pain during sex

These are usually caused by something benign, but they should be checked promptly rather than waiting for routine screening.

Useful Links

• Cervical Cancer Screening — American Cancer Society
• Cervical Cancer: Screening — U.S. Preventive Services Task Force
• Cervical Cancer Screening — Centers for Disease Control and Prevention
• HPV Self-Swab — 617 Primary Care
• Immunizations & the HPV Vaccine — 617 Primary Care