Screening for cervical cancer by regular Pap tests should be performed in all women who are or have been sexually active, and should be instituted after a woman first engages in sexual intercourse. If the sexual history is unknown or considered unreliable, screening should begin at age 18. At least two initial screening tests should be performed one year apart. For women who have had at least two normal annual smears, the screening interval may then be lengthened at the discretion of the patient and physician after considering the presence of risk factors, but should not exceed three years. Screening may be discontinued at age 65 if the following criteria are met: the woman has been regularly screened, has had two satisfactory smears, and has had no abnormal smears within the previous nine years. For all women over age 65 who have not been previously screened, three normal annual smears should be documented prior to discontinuation of screening. Clinicians should use proper techniques in collecting specimens, should submit them to qualified cytopathologic laboratories for analysis, and should provide appropriate follow up on test results.

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Routine screening for cervical cancer with Papanicolaou (Pap) testing is recommended for all women who are or have been sexually active and who have a cervix. Pap smears should begin with the onset of sexual activity and should be repeated at least every 3 years (see Clinical Intervention). There is insufficient evidence to recommend for or against an upper age limit for Pap testing, but recommendations can be made on other grounds to discontinue regular testing after age 65 in women who have had regular previous screenings in which the smears have been consistently normal. There is insufficient evidence to recommend for or against routine screening with cervicography or colposcopy, or for screening for human papilloma virus infection, although recommendations against such screening can be made on other grounds (see Clinical Intervention).