Cervical Cancer: Screening and Prevention

Aprobado por la Junta Editorial de Cancer.Net, 01/2022

ON THIS PAGE: You will find out more about screening for cervical cancer, including risks and benefits of screening. You will also learn about some of the things a person can do to reduce their risk of developing cervical cancer. Use the menu to see other pages.

Prevention

Cervical cancer can often be prevented by having regular screenings with Pap tests and human papillomavirus (HPV) tests to find any precancers and treat them. It can also be prevented by receiving the HPV vaccine.

The HPV vaccine Gardasil is approved by the U.S. Food and Drug Administration (FDA) for prevention of cervical cancer caused by HPV (see Risk Factors) for people between ages 9 and 45. Gardasil 9 is available in the United States for preventing infection from HPV16, HPV18, and 5 other types of HPV linked with cancer. There were 2 other vaccines previously available in the United States: Cervarix and the original Gardasil. However, because of newer vaccines becoming available, these 2 are no longer available in the United States. However, these vaccines may still be in use outside of the United States.

To help prevent cervical cancer, HPV vaccination is recommended for all adolescents as part of their routine vaccines. It may be given starting at age 9. Talk with your health care provider about the appropriate schedule for vaccination as it may vary based on many factors, including age, gender, and vaccine availability. Learn more about HPV vaccination and the American Society of Clinical Oncology's (ASCO's) recommendations for preventing cervical cancer.

Additional actions people can take to help prevent cervical cancer include:

  • Delaying first sexual intercourse until the late teens or older

  • Limiting the number of sexual partners

  • Practicing safer sex by using condoms and dental dams

  • Avoiding sexual intercourse with people who have had many partners

  • Avoiding sexual intercourse with people who are infected with genital warts or who show other symptoms

  • Quitting smoking

Screening information for cervical cancer

Screening is used to detect precancerous changes or early cancers before signs or symptoms of cancer occur. Scientists have developed, and continue to develop, tests that can be used to screen a person for specific types of cancer before signs or symptoms appear. The overall goals of cancer screening are to:

  • Reduce the number of people who die from the cancer, or completely eliminate deaths from the cancer

  • Reduce the number of people who develop the cancer

Learn more about the basics of cancer screening.

The following tests and procedures may be used to screen for cervical cancer:

  1. HPV test. This test is done on a sample of cells removed from the cervix, the same sample used for the Pap test (see below). This sample is tested for the strains of HPV most commonly linked to cervical cancer. HPV testing may be done by itself or combined with a Pap test. This test may also be done on a sample of cells collected from the vagina, which a person can collect on their own.

  2. Pap test. The Pap test has been the most common test for early changes in cells that can lead to cervical cancer. This test is also called a Pap smear. A Pap test involves gathering a sample of cells from the cervix. It is often done at the same time as a bimanual pelvic exam as part of a gynecologic checkup. A Pap test may be combined with an HPV test.

  3. Visual inspection with acetic acid (VIA). VIA is a screening test that can be done with a few tools and the naked eye. During VIA, a dilution of white vinegar is applied to the cervix. The health care provider then looks for abnormalities on the cervix, which will turn white when exposed to vinegar. This screening test is very useful in places where access to medical care is limited.

Screening for cervical cancer can be done during an appointment with a primary care doctor or a gynecologic specialist. In some areas, free or low-cost screening may be available.

Screening recommendations for cervical cancer (updated 09/2022)

Different organizations have looked at the scientific evidence, risks, and benefits of cervical cancer screening. These groups have developed screening recommendations for people in the United States.

ASCO recommends that all women receive at least 1 HPV test, at a minimum, to screen for cervical cancer in their lifetime, with general frequencies being between every 5 to 10 years. Specific recommendations may vary based on your age and the resources available in the area where you live, so talk with your doctor about how often you should be tested. ASCO recommends that women ages 25 to 65 should receive an HPV test once every 5 years. ASCO and the American Cancer Society (ACS) recommend that women 65 and older or women who have had a hysterectomy may stop screening if their HPV test results have been mostly negative over the previous 15 years.

Decisions about screening for cervical cancer are becoming increasingly individualized. Sometimes, screening may differ from the recommendations discussed above due to a variety of factors, including your personal risk factors and your health history. For example, ASCO recommends that women who have tested positive for the human immunodeficiency virus (HIV) or are immunosuppressed should receive HPV testing as soon as they are diagnosed. ASCO also recommends that people who have given birth be screened for cervical cancer 6 months after childbirth. It’s important to talk with your health care team or a health care professional knowledgeable in cervical cancer screening about how often you should receive screening and which tests are most appropriate for you.

Some questions to ask your health care provider include:

  • At what age should I start being screened for cervical cancer?

  • Should my screening include an HPV test? If so, how often?

  • Why are you recommending these specific tests and this screening schedule for me?

  • At what age could I stop being regularly screened for cervical cancer?

  • Do any recommendations change if I have had cervical dysplasia or precancer?

  • Do any recommendations change if I have human immunodeficiency virus (HIV)?

  • Do any recommendations change if I have had a hysterectomy?

  • Do any recommendations change if I am pregnant?

  • Do any recommendations change if I have had the HPV vaccine?

  • What happens if the screening shows positive or abnormal results?

Everyone should talk with their health care team about cervical cancer and decide on an appropriate screening schedule. For people at high risk for developing cervical cancer, screening is recommended at an earlier age and more often than for people who have an average risk of cervical cancer.

To view different groups’ national recommendations, visit the websites of ASCO, the American Society for Colposcopy and Cervical Pathology, the American Cancer Society, the American Congress of Obstetricians and Gynecologists, Cancer Care Ontario, the U.S. Preventive Services Task Force, and the World Health Organization. (Please note that these links will take you away from this guide to other, independent websites.)

The next section in this guide is Symptoms and Signs. It explains what changes or medical problems cervical cancer can cause. Use the menu to choose a different section to read in this guide.