Pap smear at what age? Cervical cancer screening

When it starts, when it can stop

Starts: At 21 (grade D: do not screen before 21). From 30, an HPV test or cotest every 5 years is also an option. (USPSTF, 2018)
Can stop: After 65, for women who had adequate prior screening and are not at high risk (grade D: do not screen). Also not needed after a hysterectomy with removal of the cervix, with no history of a high-grade precancerous lesion or cervical cancer. (USPSTF, 2018)

Who it is for

Women aged 21 to 65 years (people with a cervix). (USPSTF, 2018)

Test and how often

Ages 21 to 29: a Pap test (cervical cytology) every 3 years. (USPSTF, 2018)
Ages 30 to 65: a Pap test every 3 years, a high-risk HPV test alone every 5 years, or both together (cotesting) every 5 years. (USPSTF, 2018)

Start, how often, stop: final, draft and ACS side by side

Cervical cancer screening: USPSTF final 2018, USPSTF draft 2024 (not final) and American Cancer Society 2025
	USPSTF final (2018)	USPSTF draft (2024, not final)	American Cancer Society (2025)
Start	At 21	At 21	At 25
21 to 29	Pap test every 3 years	Pap test every 3 years	From 25, same options as below
30 to 65	Pap every 3 years, HPV test alone every 5 years, or both together every 5 years	HPV test alone every 5 years, collected by a clinician or by you; Pap every 3 years or both together every 5 years remain alternatives	Preferred: HPV test collected by a clinician every 5 years. Also: self-collected HPV test every 3 years, both together every 5 years, or Pap alone every 3 years
Stop	After 65 with adequate past screening and no high risk	After 65 with adequate past screening and no high risk	At 65 if recent tests were normal and screening was regular
After a hysterectomy	Not needed if the cervix was removed and there is no history of a high-grade lesion or cervical cancer	Same as final	Not needed after removal of the uterus and cervix, unless the surgery was for cancer or a precancer

The 2018 USPSTF statement is still the final one, and this site follows it. The USPSTF lists an update in progress. (USPSTF, 2018)

A draft update posted December 10, 2024 is not final. It would make an HPV test alone every 5 years the preferred choice from 30 to 65, and allow you to collect the sample yourself. (USPSTF draft, 2024, not final)

The American Cancer Society guideline differs: it starts at 25, prefers an HPV test collected by a clinician every 5 years, and if you collect the sample yourself, it says to repeat every 3 years. Self-collection uses FDA-approved kits ordered by your provider. (ACS, 2025)

Which schedule fits you depends on your history and your past results. Talk to your doctor before you change or stop screening.

Where the USPSTF draws the line

Grade C means a small net benefit, so it is offered to some people; D means do not screen; I means the evidence is not enough to decide. (USPSTF grade definitions)

Grade D: do not screen women younger than 21. (USPSTF, 2018)
Grade D: do not screen women older than 65 who have had adequate prior screening and are not otherwise at high risk. (USPSTF, 2018)
Grade D: do not screen women who had a hysterectomy with removal of the cervix and have no history of a high-grade precancerous lesion or cervical cancer. (USPSTF, 2018)

The USPSTF posted a draft update for this topic on December 10, 2024 (USPSTF draft). On our last review (2026-10-29) it was still a draft, so this page follows the final 2018 statement. We will update it when the new statement is final.

Questions people ask

Is the USPSTF changing its Pap and HPV advice?

A draft update was posted on December 10, 2024. It is a draft, not a final recommendation. It would make an HPV test alone every 5 years the preferred option from 30 to 65, collected by a clinician or by the patient. Until a final statement is published, the 2018 recommendation stands. (USPSTF draft, 2024, not final) (USPSTF, 2018)

Why does the American Cancer Society say start at 25?

The ACS guideline is a separate guideline from the USPSTF. It starts screening at 25, while the USPSTF starts at 21. Ask your doctor which one your clinic follows. (ACS, 2025) (USPSTF, 2018)

At what age should you get your first Pap smear?

At 21. The USPSTF recommends against screening before 21 (grade D). (USPSTF, 2018)

How often do you need a Pap smear?

From 21 to 29, a Pap test every 3 years. From 30 to 65, a Pap test every 3 years, a high-risk HPV test alone every 5 years, or both together (cotesting) every 5 years. (USPSTF, 2018)

At what age do Pap smears stop?

After 65, for women who have had adequate prior screening and are not otherwise at high risk (grade D: do not screen). The guidelines the USPSTF cites define adequate prior screening as 3 negative Pap tests in a row or 2 negative cotests in a row in the 10 years before stopping, with the most recent within 5 years. (USPSTF, 2018)

Do I still need a Pap smear after a hysterectomy?

Not if the cervix was removed and you have no history of a high-grade precancerous lesion (CIN 2 or 3) or cervical cancer. The USPSTF recommends against screening in that case (grade D). (USPSTF, 2018)

Can I collect my own HPV sample?

The 2018 statement called patient collection a possible way to raise screening rates that still needed study. The 2024 USPSTF draft (not final) includes self-collected HPV tests from 30 to 65. The American Cancer Society allows a self-collected HPV test every 3 years, with an FDA-approved kit your provider orders. (USPSTF, 2018) (USPSTF draft, 2024, not final) (ACS, 2025)

Does Medicare pay for Pap smears?

Medicare Part B covers a Pap test and pelvic exam once every 24 months in most cases, and once every 12 months if you are at high risk, or of child-bearing age with an abnormal Pap test in the past 36 months. It covers an HPV test with the Pap test once every 5 years from 30 to 65. You pay nothing if the provider accepts assignment. (Medicare.gov)

Source

U.S. Preventive Services Task Force, "Cervical Cancer: Screening", final recommendation released August 21, 2018. Read it on uspreventiveservicestaskforce.org. Checked against the live page on 2026-10-29.