New Cervical Cancer Screening Guidelines: ACS & HRSA Updates (2026)

Updated guidelines for cervical cancer screening, released in late 2025 and early January 2026, offer women more options for protecting their health, including the possibility of self-collected samples for HPV testing. The Health Resources and Services Administration (HRSA), a part of the Department of Health and Human Services, announced the updated recommendations, which largely align with new guidelines from the American Cancer Society (ACS).

HPV Primary Testing Preferred

Both HRSA and the ACS now recommend that women at average risk, aged 30 to 65, undergo primary testing for high-risk human papillomavirus (hrHPV). This approach looks specifically for the types of HPV most often linked to cervical cancer, which cause approximately 70% of these cancers. If hrHPV primary testing isn’t available, both organizations suggest co-testing – an HPV test combined with a Pap test (also known as cytology). If neither of those options are available, a Pap test alone remains an acceptable screening method.

Self-Collection Now an Option

A significant change in the guidelines is the acceptance of self-collected HPV tests. Traditionally, samples for both HPV and Pap tests were collected by a healthcare provider during a pelvic exam. While the ACS still prefers provider collection, they acknowledge that this isn’t always feasible or comfortable for all individuals. HRSA also endorses self-collection as a valid screening option. This expanded access could be particularly beneficial for individuals who lack access to a gynecologist or who experience discomfort with traditional pelvic exams.

Screening Frequency and Cessation

The frequency of screening depends on the type of test used and the method of sample collection. Women who receive HPV primary testing or co-testing with provider-collected samples and have normal results should be rescreened in five years. The ACS specifies that women who self-collect samples for HPV testing and receive normal results should be screened again in three years, a distinction not included in the HRSA guidelines. For those who receive only a Pap test and have normal results, rescreening is recommended every three years. Individuals with abnormal results will likely require more frequent monitoring.

Both sets of guidelines suggest that screening can generally be stopped at age 65 if previous test results have been consistently normal. The ACS is more specific, recommending cessation after a decade of normal results – meaning negative HPV tests at ages 60 and 65, or three consecutive negative Pap tests, with the most recent at age 65. HRSA’s guidelines end screening at 65 but are less detailed regarding prior test history.

Differences in Starting Age

There is some divergence in recommendations regarding the age to begin screening. The ACS suggests starting at age 25, citing the rarity of cervical cancer in younger individuals. HRSA, however, recommends Pap tests every three years for women aged 21 to 29, transitioning to HPV primary testing or co-testing at age 30.

What This Means for Patients

The specific screening test offered will likely depend on what a patient’s healthcare provider offers. With both guidelines favoring HPV primary testing, a shift towards this method is anticipated in the coming years.

HRSA’s guidelines also have implications for insurance coverage. Starting January 1, 2027, most insurance plans will be required to cover all recommended testing options, as well as any necessary follow-up testing, without cost-sharing for the patient. This aims to remove financial barriers to screening.

The availability of self-collected HPV tests has the potential to expand cervical cancer screening beyond traditional gynecological settings. Screening could be offered in primary care offices, urgent care clinics, mobile health units, and even some pharmacies. Alternatively, individuals may be able to collect their own samples at home. This increased accessibility could benefit those who lack access to a gynecologist or who feel uncomfortable with vaginal exams.

the most important step is for all individuals with a cervix to undergo regular cervical cancer screening. Anyone with questions about their screening needs or which test is most appropriate should consult with a healthcare provider.