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Cervical cancer screening recommendations: Examples of guidance from selected resource-abundant countries

Cervical cancer screening recommendations: Examples of guidance from selected resource-abundant countries
Country Age to initiate screening (years) Screening method and frequency Age to discontinue screening (years) Organized screening program? HPV self-collection
United States United States Preventive Services Task Force (2018)[1] 21

Ages 21 to 29: cytology alone every 3 years

Ages 30 to 65:

  • Cytology alone every 3 years
  • or
  • HPV testing alone every 5 years
  • or
  • HPV testing plus cytology every 5 years
65 provided there is no history of cervical dysplasia and:
  • 3 negative Pap test results in a row
  • or
  • 2 negative HPV tests in a row
  • or
  • 2 negative co-test results in a row within the past 10 years; the most recent test should have been performed within the past 3 or 5 years, depending on the type of test
No Yes*
American Cancer Society (2020)[2] 25

HPV testing every 5 years (preferred)

or

HPV testing plus cytology every 5 years

or

Cytology alone every 3 years

Australia (2022)[3] 25 HPV testing alone every 5 years 70 to 74 if HPV negative Yes Yes
Austria (2019)[4,5] 20 Cytology annually No upper limit Some counties No
Belgium (2025)[6] 25

Ages 25 to 29: cytology every 3 years

Ages 30 to 65: HPV testing every 5 years

65 if cytology and HPV negative Some regions No
Canada (2024)[7,8] 21 or 25

Cytology every 3 years

or

HPV testing every 5 years

65 to 70 if 3 successive negative Pap test results in the previous 10 years Some provinces Some provinces
Denmark (2021)[9] 23

Ages 23 to 29: cytology every 3 years

Ages 30 to 64: HPV testing every 5 years

60 to 64 if HPV negative Yes No
France (2018)[10] 25

Ages 25 to 29: cytology every 3 years

Ages 30 to 65: HPV testing every 5 years

65 Yes No
Germany (2020)[11] 20

Ages 20 to 34: cytology annually

Ages over 35: HPV testing plus cytology every 3 years

No upper limit Yes No
Greece (2024)[12] 21

Ages 21 to 29: cytology every 3 years

Ages 30 to 65: HPV testing every 5 years

65 Yes No
Ireland (2020)[13] 25

Ages 25 to 29: HPV testing every 3 years

Ages 30 to 65: HPV testing every 5 years

60 to 65 Yes No
Italy (2022)[14] 25

Ages 25 to 29: cytology every 3 years

Ages 30 to 64: HPV testing every 5 years

64 Yes No
Japan (2020)[15] 20 Cytology every 2 years 69 Some regions No
Netherlands (2017)[16] 30

Ages 30 to 35: HPV testing alone every 5 years

Ages 40 to 60: HPV testing alone every 5 years if HPV positive or never screened

Ages 40 to 60: HPV testing alone every 10 years if HPV negative

60

If HPV positive, final screening at 65

Yes Yes
New Zealand (2023)[17] 25 HPV testing alone every 5 years 70 to 74 if HPV negative in the last 5 years   Yes
Portugal (2024)[18] 25 HPV testing every 5 years 60 Yes No
Spain (2019)[19] 25

Ages 25 to 34: cytology every 3 years

Ages 35 to 65: HPV testing every 5 years

65 Yes No
Sweden (2022)[20,21] 23

Ages 23 to 49: HPV testing every 5 years

Ages 50 to 70: HPV testing every 7 years

70 Yes Yes
United Kingdom (2024)[22] 25

Ages 25 to 49: HPV testing every 3 years

Ages 50 to 64: HPV testing every 5 years

64 Yes No
This table provides cervical cancer screening recommendations from a representative subset of resource-abundant countries.

HPV: human papilloma virus.

* Only certain HPV tests have been approved by the US Food and Drug Administration for self-collection. This is discussed in related UpToDate content.

¶ Most provinces have adopted the age of 25 years to begin screening.

References:
  1. Cervical cancer: Screening. U.S. Preventive Services Task Force. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/cervical-cancer-screening (Accessed on March 7, 2025).
  2. Fontham ET, Wolf AM, Church TR, et al. Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society. CA Cancer J Clin 2020; 70:321.
  3. Summary of recommendations. Cancer Council Australia. https://www.cancer.org.au/clinical-guidelines/cervical-cancer/cervical-cancer-screening/summary-of-recommendations (Accessed on March 7, 2025).
  4. Cancer screening for cervical cancer. Federal Ministry Republic of Austria for Social Affairs, Health, Care and Consumer Protection. https://www.sozialministerium.at/Themen/Gesundheit/Nicht-uebertragbare-Krankheiten/Krebs/Krebsvorsorge-bei-Geb%C3%A4rmutterhalskrebs.html (Accessed on March 7, 2025)
  5. Breitenecker G, Wiener H, Stani J. Cervical cancer screening in Austria. Eur J Cancer 2000; 36:2189.
  6. Preventive care. Healthy Belgium. https://www.healthybelgium.be/en/health-system-performance-assessment/specific-domains/preventive-care#P8 (Accessed on May 20, 2025).
  7. Cervical screening in Canada, 2023-24. Canadian Partnership Against Cancer. https://www.partnershipagainstcancer.ca/topics/cervical-screening-canada-2023-2024/programs/guidelines/ (Accessed on March 7, 2025).
  8. Summary of recommendations for clinicians and policy-makers. Canadian Task Force on Preventive Health Care. https://canadiantaskforce.ca/guidelines/published-guidelines/cervical-cancer/ (Accessed on March 7, 2025).
  9. Screening for cervical cancer. National Board of Health, Danish Health Authority. https://www.sst.dk/da/Borger/Sygdomme-og-lidelser/Kr%C3%A6ftsygdom/Screening-for-kraeft/Livmoderhalskraeft (Accessed on March 7, 2025).
  10. Cervical cancer screening program. Public Health France. https://www.santepubliquefrance.fr/maladies-et-traumatismes/cancers/cancer-du-col-de-l-uterus/articles/programme-de-depistage-du-cancer-du-col-de-l-uterus (Accessed on March 7, 2025).
  11. Cervical cancer screening program. German Federal Joint Committee (G-BA). https://www.g-ba.de/themen/methodenbewertung/erwachsene/krebsfrueherkennung/gebaermutterhalskrebs-screening/ (Accessed on March 7, 2025).
  12. Presentation of the National Screening Program PREVENT. Greek Ministry of Health. https://www.moh.gov.gr/articles/ministry/grafeio-typoy/press-releases/12378-paroysiash-toy-ethnikoy-programmatos-prosymptwmatikoy-elegxoy-laquo-prolambanw-raquo (Accessed on March 7, 2025).
  13. Who should have cervical screening. Health Service Executive Ireland. https://www2.hse.ie/conditions/cervical-screening/who-should-have-cervical-screening/who-should-have-screening/ (Accessed on March 7, 2025).
  14. Bechini A, Cosma C, Di Pisa G, et al. Human papilloma virus vaccination and cervical screening in the Italian regions: An overview of the current state of the art. Vaccines (Basel) 2024; 12:504.
  15. Palmer MR, Saito E, Katanoda K, et al. The impact of alternate HPV vaccination and cervical screening strategies in Japan: A cost-effectiveness analysis. Lancet Reg Health West Pac 2024; 44:101018.
  16. Cervical cancer. Bevolkingsonderzoek Nederland. https://www.bevolkingsonderzoeknederland.nl/en/cervical-cancer/the-invitation/ (Accessed on March 7, 2025).
  17. Clinical practice guidelines for cervical screening in Aotearoa New Zealand. Te Whatu Ora, Health New Zealand. https://www.tewhatuora.govt.nz/assets/Our-health-system/Screening/HPV-Primary-Screening/clinical_practice_guidelines_final_version_1.1.pdf (Accessed on March 7, 2025).
  18. Cervical cancer screening. Government of the Portuguese Republic – Ministry of Health. https://www.sns24.gov.pt/tema/prevencao-e-cuidados-de-saude/rastreio-do-colo-do-utero/ (Accessed on March 7, 2025).
  19. Screening programs: General information. Government of Spain, Ministry of Health. https://www.sanidad.gob.es/areas/promocionPrevencion/cribado/cribadoCancer/cancerCervix/infoGeneral.htm (Accessed on March 7, 2025).
  20. Dillner J, Arroyo Muhr LS, Kleppe SN, et al. The Swedish Cervical Screening Cohort. Sci Data 2024; 11:697.
  21. HPV self-sampling in Sweden leading to faster elimination of cervical cancer. World Health Organization. https://www.who.int/europe/news/item/08-09-2022-hpv-self-sampling-in-sweden-leading-to-faster-elimination-of-cervical-cancer (Accessed on March 7, 2025).
  22. Cervical screening: Programme overview. National Health Service England. https://www.gov.uk/guidance/cervical-screening-programme-overview (Accessed on March 7, 2025).
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