Cervical Cancer Screening in 2025 Looks Easier Than in 2016, But the Tradeoffs Matter
What actually changed, what did not, and why clarity about risk now matters more than ever.
Study referenced
Christine B, Bush M, Thurakal A, Sheehy AM. New Cervical Cancer Screening Guidelines From the US Department of Health and Human Services. JAMA. Published online January 5, 2026. doi:10.1001/jama.2025.26456
What screening meant in 2016
Under the 2016 HRSA Women’s Preventive Services Guidelines, cervical cancer screening was explicitly clinician-centered. Average-risk women aged 21 to 29 were screened with cervical cytology every 3 years. Women aged 30 to 65 could choose cytology every 3 years or cotesting with cytology and high-risk HPV testing every 5 years. Screening required an office visit and clinician specimen collection. High-risk women were excluded from these pathways and managed with individualized, more intensive surveillance.
High risk was defined as women with human immunodeficiency virus infection, immunocompromise from another cause, in utero diethylstilbestrol exposure, or prior treatment for cervical intraepithelial neoplasia grade 2 or higher.
What changed in 2025
The 2025 update shifts the default for average-risk women aged 30 to 65 to primary high-risk HPV testing every 5 years, with patient-collected samples explicitly endorsed. Follow-up tests needed to complete the screening process are now covered without cost sharing, and patient navigation services are included.
Importantly, the definition of high-risk women did not change. The same groups remain excluded from self-collection and routine pathways. Self-collection applies only to average-risk women using FDA-approved tests.
Why this is not just a technical update
For the average woman, screening in 2025 appears simpler: fewer pelvic exams, longer intervals, and the option to self-collect. That is a real access gain. However, responsibility has shifted. Risk identification, proper sampling, follow-up, and understanding results now rely more heavily on patients navigating a fragmented system.
The science did not change. The delivery model did. When screening becomes less clinician-mediated, misclassification of high-risk women becomes a real concern, not a theoretical one. Convenience should not be confused with safety.
This is a dangerous move for patients who do not or cannot avail themselves to regular periodic evaluations and healthcare maintenance. The science is simple - HPV testing implies infection of the cervical cells with a virus that has the potential to alter the cell’s DNA to a pre-cancerous or malignant state. If a cell is infected, in the early part of the life cycle, the cell is programmed to make more HPV viruses and release them at the expense of the cell. That’s when HPV can be detected. Most women clear the infection at this point, making it a transient episode. For some, the HPV is not cleared and stays in the cells, with some cells incorporating the HPV DNA into the cell’s DNA. Once the HPV has integrated into the cell’sDNA the cell no longer releases HPV. It’s these women, who haven’t had screening in years, that will get missed. Cytology isn’t perfect, it’s a screening tool - but it does a better job identifying those women who have CIN3 with a negative HPV test.