Cervical cancer screening updates are a major step forward in saving lives

Cervical cancer screening is hailed as one of the most important public health achievements of the 20th century, and rightly so. Over the past 50 years, cervical cancer deaths in the United States have decreased more than 50%, thanks to the HPV vaccine, Pap tests and HPV testing.

But saving lives requires women to come in for these tests – something too few women are doing today. About half of all women diagnosed with cervical cancer have never been screened or are not up to date on screening, reports the U.S. Preventive Services Task Force.

How do you screen women for cervical cancer if they don’t come in for the test? Send the test to them.

The innovative approach is one of several major changes to cervical cancer screening announced by the U.S. Department of Health and Human Services earlier this month. The goal: to remove barriers, make testing easier and save more lives.

Highlights of the recent changes include:

• A new self-collection option for HPV testing.
• Updated guidelines that designate HPV testing as the preferred screening approach – versus a Pap smear – for women ages 30 to 65 at average risk, with testing every 5 years. (Pap tests also are still an option.)
• A mandate for most insurance companies to cover the cost of additional testing needed to complete the screening process for possible malignancies, beginning Jan. 1, 2027.

Learn more about screening for cervical cancer at home.

Below, gynecologic oncologist Dr. Anthony Costales, an assistant professor of obstetrics and gynecology and a member of the Dan L Duncan Comprehensive Cancer Center at Baylor, discusses the importance of cervical cancer screening and what women need to know about the new recommendations.

Cervical cancer screening saves lives

“Regular screening is the key to saving lives, enabling us to prevent or catch cervical cancer early, when it’s most treatable,” Costales emphasized.

With early detection, the 5-year survival rate for cervical cancer is greater than 90%. In advanced cases, where the cancer has metastasized, it drops to 20%, according to the National Cancer Institute.

Other governing bodies also have changed their recommendations for cervical cancer screening, Costales noted, including the American Cancer Society. “Their preference today is also screening every five years using HPV testing and allowing for self-collection.”

While HPV-only testing is recommended, since more than 90% of cervical cancers are caused by HPV, Costales said it’s still acceptable to do both the HPV test and Pap smear, an approach known as “co-testing” that can eliminate the need for a return visit if the HPV test comes back positive.

“These new recommendations also don’t mean that we don’t want to see you for five years,” Costales added. “Annual well-woman exams enable us to detect things like changes in the size of the uterus, whether the cervix is enlarged, if there are any ovarian masses and other abnormalities.”

For women ages 21 to 29, the government’s recommendation remained the same, he noted: cervical cancer screening every three years using a Pap test alone. “Younger women have stronger immune systems, enabling them to fight and clear the HPV virus on their own,” Costales explained.

The importance of the HPV vaccine

“It’s important to remember that preventing cervical cancer is also possible with the HPV vaccine, which protects against nine strains of HPV today,” Costales said. “The vaccine is recommended between the ages of 9 and 12, before sexual debut, but can be given any time between ages nine and 45. Condoms during intercourse are another prevention tool, since HPV is transmitted sexually. Keep in mind, HPV can also be contracted orally and through other forms of intercourse.”

Cervical cancer treatment

For women diagnosed with cervical cancer, surgical treatment is usually only an option during the earliest stages of the disease.

“That’s why screening and early detection are so important,” Costales said. “For patients with advanced cervical cancer, treatment is typically chemotherapy, radiation and immunotherapy without removal of the uterus and cervix, or chemo alone in very advanced stages.”

The cost of cervical cancer treatment

Helping more women get screened also offers a secondary benefit, Costales added: it will reduce the significant financial burden of cervical cancer treatment. “In the U.S, $2.3 billion was spent on medical care for cervical cancer in 2020. We anticipate that number will be much higher for 2025. Most treatments today for patients with advanced cervical cancer incorporate immunotherapy. These newer treatments, although they may work and help cure more patients and provide life-sustaining options, are expensive. Prevention and early identification, however, remain the keys to saving lives.”

The updated cervical cancer screening guidelines

Learn more about the updated cervical cancer screening guidelines from the Health Resources and Services Administration, part of the U.S. Department of Health and Human Services.

By Sharon Dearman, writer in the Department of Obstetrics and Gynecology