Tom Wade MD

Today, I review, link to, and excerpt from the American College of Obstetrics and Gynecology‘s “Screening For Cervical Cancer”. [PubMed Abstract] [Full-Text HTML] [Full-Text PDF]. Obstet Gynecol. 2026 Jul 1;148(1):e63-e67. doi: 10.1097/AOG.0000000000006257. Epub 2026 Apr 24.

All that follows is from the above resource.

Abstract

This committee statement announces the American College of Obstetricians & Gynecologists’ qualified endorsement of the 2026 Women’s Preventive Services Initiative’s (WPSI) updated cervical cancer screening guidelines and addresses cervical cancer screening for patients at average risk in the following age categories: 21–29 years, 30–65 years, and older than 65 years. This committee statement discusses specific qualifications to the WPSI guidelines, particularly regarding self-collection for primary high-risk human papillomavirus screening, among other implementation considerations.

SUMMARY OF RECOMMENDATIONS

The American College of Obstetricians & Gynecologists (ACOG) endorses the Women’s Preventive Services Initiative’s (WPSI) updated cervical cancer screening recommendations for patients at average risk (1). The WPSI recommendations are adopted by the U.S. Department of Health and Human Services’ Health Resources & Services Administration’s (HRSA) Women’s Preventive Services Guidelines and were updated in January 2026. This endorsement includes specific qualifications, as noted in the following recommendations (the recommendations are also summarized in Table 1):

• Individuals aged 21–29 years should be screened for cervical cancer every 3 years with cervical cytology alone.
• Individuals aged 30–65 years should undergo clinician-collected primary high-risk human papillomavirus (hrHPV) screening every 5 years, using U.S. Food and Drug Administration–approved tests for primary screening.
• Co-testing with hrHPV and cervical cytology every 5 years for individuals aged 30–65 years is acceptable when primary hrHPV testing is not available or, after counseling, the patient chooses co-testing. Patient-collected primary hrHPV screening every 3 years, using U.S. Food and Drug Administration–approved testing kits, may be considered when systems are in place for appropriate notification and follow-up.
• Cervical cytology alone for individuals aged 30–65 years should be used only in settings in which primary hrHPV testing or co-testing is not available or if, after counseling, the patient chooses cervical cytology alone.
• Routine screening is not clinically indicated in patients older than age 65 years if they have received adequate prior screening, defined as three consecutive negative cytology results or two consecutive negative co-testing results within 10 years before stopping screening, with the most recent test occurring within 3 years for cytology alone or 5 years if co-testing is used. For patients older than age 65 years who have not received adequate prior screening according to the criteria described or who are at high-risk for cervical cancer, screening should continue.
• Routine cervical cancer screening is not recommended for patients who have undergone hysterectomy with removal of the cervix and who do not have a history of cervical cancer or another high-grade precancerous lesion.

Table 1.

Summary of Recommendations for Cervical Cancer Screening for Patients at Average Risk

BACKGROUND

ACOG has updated its cervical cancer screening recommendations based on the 2026 update to the WPSI cervical cancer screening recommendations, adopted by the HRSA (1). This Committee Statement addresses cervical cancer screening for patients at average risk and does not include clinical recommendations regarding surveillance after diagnostic testing or treatment for a preinvasive or invasive lesion, although the HRSA Women’s Preventive Services Guidelines do address that additional testing and follow-up findings from initial screening may be required to complete the screening process (1). Guidance regarding management of cervical cancer screening abnormalities, including appropriate follow-up and testing, can be found in the “2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors” and the “Enduring Consensus Cervical Cancer Screening and Management Guidelines” (2–4).

These recommendations do not apply to patients with human immunodeficiency virus (HIV), immunocompromised patients without HIV, and patients with in-utero diethylstilbesterol (DES) exposure (1). Of note, patient-collected hrHPV testing (also known as self-collected hrHPV testing or self-collection) previously had not been included in major organizational screening guidelines as an option but is addressed in the updated recommendations. This Committee Statement replaces the Practice Advisory “Updated Cervical Cancer Screening Guidelines” (originally published in 2021); updates screening recommendations; and addresses implementation considerations, particularly related to patient-collected hrHPV testing options.

CONCLUSION

In summary, ACOG endorses the current HRSA–WPSI updated cervical cancer screening guidelines, but with qualifications as listed. Although there may be slight differences between the ACOG recommendations and the WPSI recommendations, the most significant overarching principle is to maximize the opportunity for and access to screening. Underscreening, or no screening, is the most significant contributor to the development of cervical cancer. Continued efforts to have screening available and accessible to all eligible patients are warranted.