Cervical Cancer Screening in United States

United States

Screening is an important tool for the early detection of cervical cancer. Routine Pap tests have contributed to significant declines in cervical cancer mortality over the past 40 years, with incidence and mortality rates decreasing by more than 50% due to increased screening. Despite this progress, the American Cancer Society (ACS) estimates that there will be approximately 13,500 new cases of invasive cervical cancer and 4,200 cervical cancer deaths in 2026. The leading cause of cervical cancer is the human papillomavirus (HPV), a group of common viruses transmitted during sexual contact. It is estimated that nearly all sexually active people will get HPV at some point during their lifetimes, but recommended HPV vaccinations effectively protect against and reduce rates of cancer-causing strains. 

Increasing cervical cancer screening rates can reduce health care costs and save lives. Screening helps detect HPV infection and precancerous cells, making early-stage cervical cancer easier and less expensive to treat. Based on data from 2014-2018, the total direct medical cost of HPV-associated diseases is estimated at $9.01 billion annually in 2020 dollars. This includes both treatments and screenings, with 55% of costs attributed to routine cervical screening and follow-up services. These screening costs reflect their widespread use for prevention and early detection, helping to reduce the need for more costly treatment, which accounts for approximately 44% of HPV-attributed cancer costs. The Centers for Disease Control and Prevention (CDC) estimated that in 2020, cervical cancer care alone cost $2.3 billion, averaging about $97,000 per patient.

According to America’s Health Rankings analysis, the prevalence of cervical cancer screening is higher among:

• Non-Hispanic white and multiracial women compared with Asian women. 
• Women ages 35-44 compared with those ages 25-34.
• Women with a college degree compared with those who have less than a high school education.
• Women with an annual household income of $75,000 or more compared with those who have an income less than $25,000. The prevalence is higher with each income level.
• Women without a disability compared with those who have difficulty with mobility.

Additional studies have found that rates of cervical cancer screening are higher among:

• Women with a usual source of care compared with those who have none, or who use emergency departments for care.
• Women with insurance compared with those without insurance. Women with Medicaid coverage also have low screening rates.

The CDC recommends regular screening via Pap and/or HPV tests, as well as HPV vaccination in early adolescence, to prevent cervical cancer. The U.S. Preventive Services Task Force (USPSTF) strongly recommends that women ages 21-29 undergo a Pap test every three years. For women ages 30-65, the USPSTF recommends either: a) a Pap test every three years, b) HPV testing every five years, or c) a combined HPV and Pap test every five years. 

The ACS cervical cancer screening guidelines have expanded to include a self-collection sample test option for average-risk women to increase accessibility and early detection. 

Women with HIV are at higher risk of cervical cancer and should follow the screening recommendations in the federally-approved clinical Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV.

The Community Guide lists several evidence-based interventions for increasing cervical cancer screening, including:

• Interventions involving community health workers, which have reduced barriers to access and increased demand for screening services.
• Multicomponent interventions, which combine two or more evidence-based approaches to reduce structural barriers (such as reducing administrative barriers, assisting with appointment scheduling, addressing transportation barriers or offering child care). 

Programs like the National Breast and Cervical Cancer Early Detection Program (NCBCCEDP) support access to free and low-cost breast and cervical cancer screenings and diagnostic services. In 2024, NBCCEDP provided services to nearly 285,000 women.

Health care providers should recommend and/or educate patients on screening during routine visits. Direct communication between patients and providers has been shown to increase screening rates and can be effective among populations of women whose cultural beliefs and practices may conflict with screening recommendations.

Healthy People 2030 aims to increase the proportion of women ages 21-65 who receive cervical cancer screening. 

Clay, Patrick A., Trevor D. Thompson, Lauri E. Markowitz, Donatus U. Ekwueme, Mona Saraiya, and Harrell W. Chesson. “Updated Estimate of the Annual Direct Medical Cost of Screening and Treatment for Human Papillomavirus Associated Disease in the United States.” Vaccine 41, no. 14 (March 2023): 2376–81. https://doi.org/10.1016/j.vaccine.2023.02.049.

Dorsainvil, Merlyn A. “Increasing Cervical Cancer Screening in Underserved Populations.” Journal of Christian Nursing 34, no. 3 (July 2017): 152–58. https://doi.org/10.1097/CNJ.0000000000000405.

Ezeigwe, Ogochukwu Juliet, Samuel Tundealao, Ogochukwu Ruth Abasilim, Olajumoke Ope Oladoyin, Manali Desai, Devesh Malgave, Lekan Ajijola, and Xianglin L. Du. “Impact of Patient-Physician Communication on Cervical Cancer Screening among Women Aged 25–65.” Journal of Medicine, Surgery, and Public Health 5 (April 2025): 100182. https://doi.org/10.1016/j.glmedi.2025.100182.

Perkins, Rebecca B., Andrew M. D. Wolf, Timothy R. Church, Elena B. Elkin, Steven J. Skates, Ruth D. Etzioni, Carmen E. Guerra, et al. “Self-collected Vaginal Specimens for Human Papillomavirus Testing and Guidance on Screening Exit: An Update to the American Cancer Society Cervical Cancer Screening Guideline.” CA: A Cancer Journal for Clinicians 76, no. 1 (January 2026): e70041. https://doi.org/10.3322/caac.70041.

Sabatino, Susan A., Trevor D. Thompson, Mary C. White, Jean A. Shapiro, Tainya C. Clarke, Jennifer M. Croswell, and Lisa C. Richardson. “Cancer Screening Test Use?U.S., 2019.” American Journal of Preventive Medicine 63, no. 3 (September 2022): 431–39. https://doi.org/10.1016/j.amepre.2022.02.018.