Cervical cancer screening FAQs: Key updates from HRSA-supported guidelines

January is Cervical Cancer Awareness Month, and this year’s observance coincides with newly finalized cervical cancer screening recommendations from the Women’s Preventive Services Initiative (WPSI), according to guidance published January 5, 2025, in Federal Register. The updated recommendations apply to average-risk women aged 21 to 65 years and designate primary high-risk human papillomavirus (hrHPV) testing every 5 years as the preferred screening approach for most women aged 30 to 65 years. The guidance also formally incorporates patient-collected hrHPV testing as an appropriate screening option within this age group.¹

In addition to updates to screening modality and interval, the guideline clarifies that additional diagnostic testing required to complete the cervical cancer screening process—such as cytology, biopsy, colposcopy, extended genotyping, dual stain testing, and pathologic evaluation—is also recommended when clinically indicated. The following frequently asked questions summarize key components of the updated guidance and practical considerations for clinicians.

Quotes from Barbara Levy, MD, FACOG, FACS, clinical professor of obstetrics and gynecology at George Washington University School of Medicine and chief medical officer of Visana Health, are included where relevant for additional context.

A full discussion with Levy about the updated guidelines can be found here at the links below.

WATCH: Barbara Levy, MD, reacts to HRSA's updated cervical cancer guidelines²

WATCH: Barbara Levy, MD: Patient-collected hrHPV testing is "huge" part of updated cervical cancer guideline³

Frequently asked questions on cervical cancer screenings

1. Which patient population is covered under the updated cervical cancer screening recommendations?
The recommendations apply to average-risk women aged 21 to 65 years.

2. What is the recommended screening approach for women aged 21 to 29 years?
Women aged 21 to 29 years should undergo cervical cancer screening using cervical cytology (Pap test) alone every 3 years.

3. Is HPV testing recommended for women younger than 30 years?
No. Co-testing with cytology and hrHPV testing is not recommended for women younger than 30 years.

4. What is the preferred screening method for women aged 30 to 65 years?
Primary hrHPV testing every 5 years is the preferred screening method for average-risk women aged 30 to 65 years.

“We have known that cervical cancer is caused by certain types of the human papillomavirus since the 1980s. Testing for human papillomavirus and the high-risk types really is more sensitive and specific for what we’re trying to do.”
—Barbara Levy, MD, FACOG, FACS

5. Why does the guideline prioritize hrHPV testing over cytology-based screening in this age group?
hrHPV testing directly detects the virus responsible for cervical cancer, whereas cytology evaluates cellular changes without identifying the underlying cause.

Scraping the cells and looking at the way they look under the microscope gives us a way that the body’s responding to something, but we don’t know what. This is a much, much more specific test.”
—Barbara Levy, MD, FACOG, FACS

6. What alternative screening options are acceptable for women aged 30 to 65 years?
Cytology and hrHPV co-testing every 5 years is an acceptable alternative. If hrHPV testing is not available, cytology alone every 3 years may be used.

7. How often should average-risk women be screened?
Average-risk women should not be screened more frequently than once every 3 years.

8. Why are longer screening intervals supported with hrHPV testing?
The recommendation reflects both the high sensitivity of hrHPV testing and the slow progression of cervical cancer.

“What we really want to capture is the ones that are persistent, because those are the ones that are at risk.”
—Barbara Levy, MD, FACOG, FACS

9. Is patient-collected hrHPV testing included in the recommendations?
Yes. Patient-collected hrHPV testing is considered an appropriate method and should be offered as an option for cervical cancer screening in average-risk women aged 30 to 65 years.

10. What additional testing is recommended to complete the screening process when clinically indicated?
Additional testing may include cytology, biopsy, colposcopy, extended genotyping, dual stain testing, and pathologic evaluation.

“We trained the public really well to say that you’ve got to go in every year to prevent cervical cancer. So we’ve got a lot of work to do to help people understand both the sensitivity of the virus test and the cadence of how often it really needs to be done.”
—Barbara Levy, MD, FACOG, FACS

References:

1. Update to the women’s preventive services guidelines. Health Resources & Services Administration. Federal Register. Published January 5, 2026. Accessed January 30, 2026. https://www.federalregister.gov/documents/2026/01/05/2025-24235/update-to-the-womens-preventive-services-guidelines
2. Fitch J. Barbara Levy, MD, reacts to HRSA's updated cervical cancer guidelines. Contemporary OB/GYN. Published January 20, 2026. Accessed January 30, 2026. https://www.contemporaryobgyn.net/view/barbara-levy-md-reacts-to-hrsa-s-updated-cervical-cancer-guidelines
3. Fitch J. Barbara Levy, MD: Patient-collected hrHPV testing is "huge" part of updated cervical cancer guideline. OB/GYN. Published January 22, 2026. Accessed January 30, 2026. https://www.contemporaryobgyn.net/view/barbara-levy-md-patient-collected-hrhpv-testing-is-huge-part-of-updated-cervical-cancer-guideline