At the end of 2025, the American Cancer Society (ACS) released its new cervical cancer screening guidelines. In January 2026, the Health Resources and Services Administration (HRSA), part of the Health and Human Services Department (HHS), endorsed a new set of guidelines as well.

The two sets of guidelines agree on most issues, but there are a few differences.

Where the Guidelines Agree

• The HPV Primary Test is Preferred. Both groups recommend that providers use an HPV primary test for patients of average risk from the age of 30-65. This test looks for the types of HPV (human papillomavirus) that are known to cause about 70% of cervical cancers. If the HPV primary test is not available, the groups recommend co-testing. Co-testing involves an HPV test done at the same time as a Pap test (also called cytology). If this is not available, both groups say providers can use a Pap test alone.
• Self-collection is acceptable. Traditionally, all samples for HPV tests or Pap tests have been collected by a health care provider during a speculum exam. The ACS prefers this method but recognizes that this can be difficult for some people or in some areas. In those cases, the ACS says that self-collected HPV tests are an acceptable alternative. HRSA also calls screening with self-collection acceptable.
• Follow up after normal results in three or five years. How often a person should get screened depends on which test(s) they were given and how the samples were collected. People who get HPV primary testing or co-testing using a provider-collected sample and have normal results should be screened again in five years. The ACS adds that people who collect their own samples for HPV testing and have normal results should be screened again in three years. This distinction is not included in the HRSA guidelines. People who only get a Pap test and have normal results should be screened again in three years. Anyone who has abnormal results will likely need to be screened more frequently.
• Screening can end at age 65 if tests results were normal. The ACS specifies that people stop screening at 65 if they have had a decade of normal results. This means that they had negative HPV tests at 60 and 65 or that they had three consecutive Pap tests that were negative, and the last one was at age 65. HRSA guidelines also end at 65, but they are less specific about past results.

Where the Guidelines Differ

• ACS suggests starting screening at 25. The ACS recommends people start screening age 25 regardless of what test they are getting. This is in part because cervical cancer is rare in younger people.
• HRSA suggests starting screening at 21. HRSA recommends people get Pap tests every three years between ages 21 and 29 and start HPV primary testing or co-testing at age 30.

What this Means for Patients

For most patients, the screening test they get will depend on what their provider offers. With both sets of guidelines preferring HPV primary testing to co-testing, more providers may switch over the next few years.

HRSA’s guidelines also carry weight with insurance companies. Most private insurances companies are required to offer all recommended testing options as well as all follow-up testing without copays. (These recommendations affect insurance policies starting in 2027.)

HPV screening with self-collection will hopefully expand cervical cancer screening beyond gynecologist’s offices. Patients could be screened at a primary care provider’s office, an urgent care clinic, a mobile clinic, or even in some pharmacies. Or they could choose to collect their sample at home. This can help people who don’t have access to a gynecologist, or those who don’t feel comfortable with vaginal exams.

Of course, the most important thing is that everyone with a cervix get screened for cervical cancer regularly. Anyone who has questions about whether they need to be screened or which test is best, should talk to a health care provider.