Screening for Cervical Cancer: A Recommendation From the Women's Preventive Services Initiative

The Women's Preventive Services Initiative (WPSI) expanded its previous cervical cancer screening recommendation for average-risk women by including patient-collected high-risk human papillomavirus (hrHPV) screening tests and additional follow-up testing needed to complete the screening process. To update the previous recommendation, the WPSI identified new evidence demonstrating that primary hrHPV screening increases detection of precancerous lesions compared with cytology screening. New studies indicate that patient-collected hrHPV testing has similar test accuracy for precancer detection compared with clinician-collected samples and may reduce barriers to screening. Consistent with the previous recommendation, the WPSI recommends cervical cancer screening for average-risk women aged 21–65 years. For women aged 21–29 years, screening using cervical cytology (Pap test) every 3 years is recommended; co-testing with cytology and hrHPV testing is not recommended for those younger than 30 years. For women aged 30–65 years, primary hrHPV testing (preferred method) or co-testing (cytology with hrHPV) every 5 years is recommended; if hrHPV testing cannot be performed, cytology every 3 years is acceptable. Women at average risk should not be screened more than once every 3 years. Patient-collected hrHPV is an appropriate screening method for average-risk women aged 30–65 years. The new recommendation—including additional testing to follow up on findings on the initial screening—was recently approved by the Health Resources & Services Administration, U.S. Department of Health and Human Services, for coverage without co-pay or deductible charges for most eligible women beginning in 2027.