Cervical Cancer Screenings: Pap Tests, HPV Tests and Pelvic Exams
Physicians and scientists now know that the human papillomavirus virus (HPV) causes most cases of cervical cancer. This discovery has led to changes in how people are tested for cervical cancer.
HPV tests and Pap smears are used to test for cervical cancer. For people ages 30 to 65 at average risk, primary HPV testing is the preferred screening method. HPV testing can be performed using a sample collected by a healthcare provider during a pelvic exam or, for some patients, a self-collected vaginal swab. The pelvic exam itself is also an important cancer detection tool.
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Our experts offer gynecological wellness and screening exams at several locations throughout the greater Chicago area.
Early Detection and Screening Guidelines
The goal of cancer screening is to identify precancerous changes or early-stage cancers that can be treated before they become advanced. Thanks to screening tests and tools, the number of people who get cervical cancer or die from the disease has decreased dramatically.
Yet many people aren’t sure when and how often they need to see a gynecologist for cervical cancer screenings. Screening guidelines have been updated frequently in recent years to reflect the latest scientific evidence.
“Complicated” is how UChicago Medicine gynecologist Shivika Trivedi Kapadia, MD, describes the screening guidelines for cervical cancer. For women looking for simple instructions to follow, Dr. Trivedi provides the following advice:
UChicago Medicine, along with the American College of Obstetrics and Gynecology, recommends an annual well-woman exam with a gynecologist for all women of reproductive age. The inclusion of a pelvic exam at this visit should be a shared decision between the patient and the gynecologist, after reviewing each patient’s personal history, symptoms, and risk for infections or cancer.
During a pelvic exam, your gynecologist can perform a cervical cancer screening test (for example, a pap smear or HPV test depending on your age). In addition, during the same appointment, your gynecologist will likely also conduct a breast exam to feel for lumps and other signs of cancer. You can also get a referral for a mammogram if you need one.
In the following Q&A, Dr. Trivedi provides more detailed information specifically about cervical cancer screenings.
Frequently Asked Questions About Cervical Cancer Screenings
Almost all cases of cervical cancer are caused by the HPV virus. The virus also causes cancers in the vagina, vulva, mouth, throat and anus (as well as the penis). There are many different types of HPV. Some high-risk types, including HPV 16 and 18, are strongly linked with cervical and other types of cancer.
The HPV virus is sexually transmitted. The CDC estimates that nearly all sexually active people will get HPV at some time in their life if they are unvaccinated. Typically, a person’s immune system can fight the infection. But if the virus remains, prolonged exposure can lead to abnormal cell changes, leading to cancer.
Getting an HPV vaccine can greatly reduce the risk of getting cervical cancers as well as other cancers linked to HPV. Boys and girls can be vaccinated as early as 9 years old. Vaccination is recommended for everyone up to the age of 26, and women can get an HPV vaccine up to the age of 45.
Other risk factors for cervical cancer include:
- Smoking
- Having a weak immune system
- Being born to a mother who took diethylstilbestrol (DES), a hormone drug used from 1940 to 1971 to prevent miscarriage
- Having a family history of cervical cancer
- Having had three or more full-term pregnancies
Any woman or transgender male who has a cervix (lower part of the uterus) needs to get screened for cervical cancer. For specifics on when you need to get which screenings, see the question below that addresses this issue.
Please note: It’s also important to consider your whole health — not just your risk of getting cervical cancer. Talk with your gynecologist about your personal risk for all cancers that affect female reproductive parts, such as ovaries, vagina, vulva and breasts. Together, decide how often and when you need to see your gynecologist for a health checkup and for various cancer screening tests and exams.
UChicago Medicine, along with ACOG, recommends an annual wellness exam with a gynecologist for all reproductively aged people. The inclusion of a pelvic exam at this visit should be a shared decision between the patient and the gynecologist, after reviewing each patient’s personal history, symptoms and risk for infections or cancer.
Two tests — pap smears and HPV tests — are currently available to screen for cervical cancer. For women ages 30 to 65 at average risk, primary HPV testing is the preferred screening method. See the table below for more information on these screening tests and exam. Some of these are used to screen for other types of cancers and health problems, too.
| Test or exam | Used to detect what disease(s) and problem(s) | What to expect |
| Pelvic exam |
|
Your gynecologist will examine your cervix as well as other pelvic areas (uterus, ovaries, vagina, vulva, rectum) to identify possible abnormalities, including signs of cancer. The exam will likely include having a speculum (a device shaped like a duck’s bill) inserted into the vagina to allow for visualization of the cervix, followed by a bimanual exam to evaluate the size and shape of the uterus and ovaries. |
| Pap smear (or Pap test) |
Identify precancerous or cancerous changes to the cervix. Pap tests can also detect certain infections. |
During a pelvic exam, your gynecologist will gently scrape cells from your cervix using a small brush. Once collected, these cells will be tested for pre-cancerous changes. |
| HPV test | An HPV infection, which is the number one cause of cervical cancer. HPV can also cause other cancers, including cancers of the vagina, vulva, mouth, throat and anus. |
For clinician-collected HPV testing, your doctor will collect cells from the cervix during a pelvic exam to test for the presence of HPV. If the test is positive, the cells of the cervix will also be tested for pre-cancerous changes. For eligible patients ages 30 and older undergoing routine cervical cancer screening, HPV testing may also be performed using a self-collected vaginal swab during a clinic visit. |
| HPV/Pap co-test | HPV infection as well as precancerous or cancerous changes to the cervix. | This co-test allows the laboratory to test the same sample of cells from your cervix for both HPV and pre-cancerous changes. This is recommended for patients who are immunocompromised or who have a history of abnormal cervical cancer screening. |
At UChicago Medicine, our gynecologists can talk to you about the most recent updates to cervical cancer guidelines. We can help identify a screening schedule that considers their risks for cervical cancer as well as their personal preferences and the latest scientific evidence.
Our gynecologists follow the endorsements of the American Society of Colposcopy and Cervical Pathology (ASCCP) related to cervical cancer screenings.
In 2026, ACOG released updated cervical cancer screening guidelines. For people at normal risk for cervical cancer, these guidelines specify the following:
| Under age 21 | No screening necessary |
| Ages 21 to 29 | Get a Pap smear every 3 years |
| Ages 30 to 65 |
The preferred screening method is:
Alternative screening options include:
At the University of Chicago, we perform primary HPV tests (either healthcare provider-collected or patient-collected) |
| After age 65 | No testing necessary if you’ve had normal tests at the appropriate frequency. |
Please note the following:
For women at high risk of cervical cancer: Screening guidelines are different for women who are immunocompromised or otherwise considered at high risk.
- For women ages 21 to 29, screening with a Pap smear is recommended annually until three consecutive normal results, then every 3 years.
- For women age 30 and older, HPV/Pap co-testing is recommended every 3 years.
- High-risk or immunocompromised patients should continue screening every 3 years throughout life.
If this describes you, talk to your gynecologist or oncologist about how often you need to get screened and which screening tests you need.
At UChicago Medicine, we offer world-class care for people with cervical and other types of gynecologic cancers, including the support you need to optimize your current and future health needs.
The HPV vaccine provides excellent protection against cervical cancer, as well as other cancers caused by HPV, such as vaginal and vulvar cancers. However, it does not provide 100% protection. For this reason, people still need to get regular cervical cancer screenings even if they’ve been vaccinated for HPV.
Of note, the complete HPV vaccination series consists of two shots if started before age 15, or three shots if started after the age of 15.
If your cervix was removed at the time of your hysterectomy (total or complete hysterectomy), and you had no prior history of precancer or cancer of the cervix, you likely do not need to continue getting cervical cancer screenings. High-risk or immunocompromised patients may need to continue screening regardless of age or hysterectomy. Talk to your gynecologist if you have questions.
HPV is very common and doesn’t usually lead to cancer. In most women who have HPV, their immune system clears the infection from their bodies within a few years.
If you had a clinician-collected primary HPV test, the cells of the cervix will then be tested for pre-cancerous changes. If you had a self-collected HPV test and the result is positive, you will need to return for a clinician-collected sample so the cells of the cervix can be tested.
To ensure any cancer is caught early, your gynecologist may recommend repeating the HPV test and/or a Pap test. When any abnormalities are suspected, you may need to undergo additional diagnostic tests, such as a biopsy.
An abnormal Pap test result can mean various things. There’s a wide breadth of abnormal results that people can have. It’s important to talk to your gynecologist or other physician and ask them to help you understand the results and what they mean for you.
You may need to have follow-up tests to uncover more information, including additional HPV or Pap tests or possibly other diagnostic tests, such as a biopsy of the cervix (a procedure called a colposcopy).
At UChicago Medicine Comprehensive Cancer Center, we have assembled a team — including gynecologic oncologists, radiation oncologists and plastic and reconstructive surgeons — who are highly experienced in diagnosing and treating all types of gynecologic cancers, including cervical cancer.