What Is an HPV Test? Who Needs One and What Results Mean
What an HPV test checks for, how it differs from a Pap smear, who should get one and how often, self-collection options and what positive results mean.
How Often Do You Need a Pap Smear? Screening Guidelines by Age
Cervical cancer screening by age: when to start, how often you need a Pap smear or HPV test, when you can stop, and what the latest US guideline changes mean.
Key takeaways
- Screening starts at 21. From 21 to 29, a Pap test every three years is recommended.
- From 30 to 65, options include an HPV test every five years, co-testing every five years or a Pap test every three years.
- Most people can stop after 65 if earlier results were normal; always confirm with your clinician.
On this page
Cervical cancer screening is one of the most successful cancer prevention tools in medicine. It finds changes in the cervix years before they could become cancer, when they are easy to treat. But the recommendations have changed over the years, and many people are unsure how often they actually need to be tested.
This guide summarises current US guidance. Your own schedule may differ depending on your history, so always confirm with your clinician.
Pap test vs HPV test
- A Pap test (Pap smear) looks for abnormal cells on the cervix.
- An HPV test looks for high-risk types of human papillomavirus, the virus that causes nearly all cervical cancers.
- Co-testing means having both at the same time.
Both use a sample of cells collected from the cervix during a speculum exam, and many clinics can run either test from the same sample.
Screening schedule by age
| Age | USPSTF recommendation (average risk) |
|---|---|
| Under 21 | No screening |
| 21–29 | Pap test every 3 years |
| 30–65 | HPV test every 5 years, or co-testing every 5 years, or Pap test every 3 years |
| Over 65 | Stop, if you have had adequate normal screening and are not at high risk |
| After hysterectomy | No screening if the cervix was removed and there is no history of precancer or cancer |
The American Cancer Society’s guideline is slightly different. Its December 2025 update recommends screening from 25 to 65, preferably with a primary HPV test every five years on a sample your clinician collects. A vaginal sample you collect yourself is an acceptable alternative, with a repeat test after three years if it’s negative. If primary HPV testing isn’t available, co-testing every five years or a Pap test every three years is acceptable. Both approaches are considered reasonable, and your clinician can help you choose.
Who may need screening more often?
You may need a different schedule if you:
- Have had an abnormal result or treatment for cervical precancer.
- Have a weakened immune system, for example from HIV or an organ transplant.
- Were exposed to the drug DES before birth.
- Have had cervical cancer.
Do you still need screening if you’ve had the HPV vaccine?
Yes. The HPV vaccine protects against the types of HPV that cause most cervical cancers, but not all of them. Vaccinated people should follow the same screening schedule.
What happens if your result is abnormal?
An abnormal result is common and usually doesn’t mean cancer. Depending on the result and your age, your clinician may recommend:
- Repeat testing in one to three years, because many HPV infections clear on their own.
- Colposcopy, a closer look at the cervix with a magnifying instrument, sometimes with a small biopsy.
- Treatment to remove abnormal cells, if needed, which is usually quick and done in the office.
Making your test more comfortable
- Ask for a smaller speculum if you find exams uncomfortable.
- Tell your clinician if you have had difficult experiences with exams before.
- Ask whether self-collection is an option for you.
- Schedule when you are not on a heavy period, unless your clinic says otherwise.
Frequently asked questions
Do I need a Pap smear every year?
Not usually. For average-risk people, screening every three or five years is recommended, depending on the test. You may still benefit from an annual well-woman visit for other care.
I’m 66 and have never had an abnormal result. Can I stop?
Many people can stop after 65 if they have had adequate recent screening with normal results and aren’t at high risk. The American Cancer Society’s 2025 update is more specific: it looks for negative HPV tests (or co-tests) at both 60 and 65, or, if HPV testing isn’t available, three negative Pap tests in a row with the last at 65. Confirm with your clinician, who can check your history.
Is an HPV test the same as a Pap smear?
No. The HPV test looks for the virus that causes cervical cancer; the Pap test looks for abnormal cells. They can be done separately or together.
Sources
- US Preventive Services Task Force — Cervical cancer screening
- ACOG — Cervical cancer screening
- American Cancer Society — Cervical cancer screening guidelines (updated December 2025)
- CDC — Cervical cancer
- Perkins RB et al. — Self-collected vaginal specimens for HPV testing and guidance on screening exit: an update to the ACS guideline (CA Cancer J Clin, 2026)
- USPSTF — Draft recommendation: cervical cancer screening (December 2024)
Every article is edited by a human and checked against our editorial policy. Spotted a mistake? Tell us.
Keep reading
Abnormal Pap Smear Results: What They Mean
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