Who should get screened for cervical cancer? At what point is it unnecessary?

TL;DR: If you are aged 21 to 65 years and have a cervix* you should be screened for cervical cancer every 3-5 years.

👏 Guess what?! The FDA just approved self-swabbing in the healthcare setting, so if the pelvic exam has been stressing you out, ask your clinician for the self-swabbing option.

*Please note, if you have had a total hysterectomy–both uterus and cervix removed– you may not need to be screened unless you have had cervical cancer or precancer. Talk to your clinician about your particular screening needs.

Screening uses either a Pap test that looks for pre-cancer or cancer cells on the cervix and/or a human papillomavirus (HPV) test that looks for the HPV virus.

HPV is the most common sexually transmitted infection in the United States. By age 50, at least 4 out of every 5 people with a cervix will have been infected with HPV at one point in their lives. For the majority of folks, the infection will clear naturally within 2 years. About 10% of people with HPV infection on their cervix will develop long-lasting HPV infections that may put them at risk for cervical cancer.

Screening is recommended regardless of HPV vaccination status. Talk with your clinician to decide which test and which time frame is most appropriate given your location and individual context.

🎉 The good news: Due to screening initiatives *and* increased rates of HPV vaccinations, cervical cancer is a cancer we can prevent altogether or treat early to prevent unnecessary suffering. 🫶🏾

❗ Rates of cervical cancer and death among Hispanic and Black folks are higher than the general population. Additionally, some folks—such as those experiencing poverty, living in rural areas, or from other minoritized groups– do not have the same access to screening services. So screening initiatives in those communities are important public health priorities.

✨ To recap:

For ages 21-65, talk to your clinician about getting screened using either the Pap test and/or the hrHPV test every 3-5 years.

✅ Don’t forget about that new self-swabbing option in your clinician’s office!

**Certain risk factors further increase one’s risk for cervical cancer, including HIV infection, a compromised immune system, exposure to diethylstilbestrol as a fetus, and previous treatment of a precancerous lesion or cervical cancer. If you have one of these risk factors or any other concerns, you should participate in an individualized discussion with your clinician.

It is also important to note that a person without a cervix may be at risk for cancers related to high-risk HPV. HPV-related cancers can also be found in the mouth, throat, and anal regions. Talk to your clinician about any concerns you have about these areas of the body.

Note: These are the *current* guidelines in the US as described by the United States Preventive Services Task Force (USPSTF). The USPSTF is now reviewing the newest research and recommendations. They will have an update soon. Stay tuned.

Love,
Those Nerdy Girls &+

Eager for more!? Here is our recent post on the HPV vaccine.

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Patient Education:

U.S. Preventive Services Task Force – Cervical Cancer: Screening [archived link]

The HPV Vaccine: Access and Use in the U.S.CDC – Human Papillomavirus (HPV) [archived link]

CDC – About HPV [archived link]

References:

FDA approves self-swabbing [archived link]

CDC- Cervical Cancer Statistics and Disparities [archived link]

NIH – Methodologies of Primary HPV Testing Currently Applied for Cervical Cancer Screening

NIH – Home Self-Collection by Mail to Test for Human Papillomavirus and Sexually Transmitted Infections