Instead of a Pap smear, federal guidelines now recommend that women ages 30 – 65 with an average risk of cervical cancer get an HPV test every five years, whether self-administered or performed by a doctor. The new guidelines say women ages 21 – 29 should still receive a Pap smear every three years.
Pap smears look for abnormal cells in the cervix that could lead to cervical cancer. HPV tests detect a variety of types of high-risk human papillomavirus that cause cervical cancer.
“The HPV test allows the clinician to know whether someone is truly at risk of cervical cancer – not the Pap smear alone,” says Monique Swain, M.D., an obstetrics and gynecology surgeon at Henry Ford Health. “You could theoretically have a normal Pap smear and a positive HPV test and still be at risk for cervical cancer, whereas an abnormal Pap smear with negative HPV testing carries substantially lower risk for cervical cancer.”
Pap Smears in Young People
Pap smears are still the gold standard screening method for women ages 21 – 29 for a few reasons. “Younger people tend to be more immunocompetent – meaning they have a strong immune response – so even if they contract HPV, their ability to clear the virus is vastly improved compared to older patients,” says Dr. Swain.
Younger women are also at less risk of developing cervical cancer than older patients. Women are most often diagnosed with cervical cancer in their 30s and 40s.
What To Know About Self-Swab HPV Tests
Three self-administered HPV tests have been FDA-approved since 2024 – but private insurance companies will be required to cover their costs beginning in 2027.
The tests are easy to use: you insert a tube into the intervaginal area to swab for cells and mail it to a lab or bring it to your doctor’s office. You can also do the test at your doctor’s office. Studies show results are as accurate as when a physician administers an HPV test themselves.
Cervical Cancer Screening at Henry Ford Health
“I think self-swab tests will improve access to cervical cancer screening, particularly among those who live in rural areas and don’t have access to an obstetrician-gynecologist, along with people who have anxiety over getting this type of exam done,” says Dr. Swain.
That said, after the initial test, you should see your doctor for follow up if results show precancerous cells are present.
“One study showed that self-administered tests improved screening rates in their patients, but another showed the tests didn’t have a high return rate – and of the women who had abnormal results, only 59% had the follow up they needed,” says Dr. Swain. “The self-administered tests are a good step, but it’s important to return the tests and follow up with your doctor if your results are abnormal.”
Rates of Cervical Cancer Are Increasing
The HPV vaccine, which can prevent more than 90% of cervical cancers, is approved for males and females ages 9 to 45. Yet even with the vaccine – and standard cervical cancer screening guidelines – rates of cervical cancer are increasing among those in their 30s and early 40s.
“Without an increase in people getting the HPV vaccine, we won’t see the reduction in cervical cancer rates that we want to see,” says Dr. Swain. “We need to continue with education – educating about the benefits of the HPV vaccine, along with the importance of cervical cancer screening and follow up before precancerous cells turn into cervical cancer.”
Reviewed by Monique Swain, M.D., an obstetrics and gynecology surgeon who sees patients at Henry Ford West Bloomfield Hospital and Henry Ford New Center One.
