Annual Cervical Cancer Testing Has Declined Nearly 40% Since 2008

When was your last Pap smear? If you have to think about it for a moment, you're probably not alone.

Between annual physicals, dental appointments, and everything else on our health to-do lists, it's easy to lose track of which screenings we're due for. And cervical cancer screening can be particularly confusing, since recommendations have changed over the years.

Some women remember being told to get a Pap smear every year, while others have been advised to wait three or even five years between tests.

In a new study1 published in the Journal of Women's Health, researchers analyzed cervical cancer screening patterns among U.S. women ages 20 to 64 between 2008 and 2023. 

Because the United States doesn't have a national cervical cancer screening registry, getting an accurate picture of screening participation is surprisingly complicated. To address this, researchers combined information from several sources, including private and public insurance claims and national health surveys.

The researchers found that the estimated percentage of women receiving a cervical cancer screening test in a given year dropped from 38% in 2008 to 23.3% in 2023.

That's a substantial decline over 15 years.

But it’s important to note that the study measured annual testing, not whether women were following recommended screening schedules. Because cervical cancer screening guidelines have shifted away from annual Pap smears, depending on age, test type, and individual risk factors, many women can safely go several years between screenings.

So while the decline is worth paying attention to, it doesn't necessarily mean that the same proportion of women are missing recommended screenings.

Another interesting finding involved how women reported their own screening habits.

The researchers' combined estimate was, on average, 22.3 percentage points lower than estimates based on self-reported survey data. That suggests surveys alone may paint an overly optimistic picture of how frequently cervical cancer testing occurs.

Here's where this research becomes especially relevant to your own health. Cervical cancer screening helps identify abnormal cervical cells and high-risk HPV infections before they potentially develop into cancer.

And unlike many other cancers, cervical cancer is often preventable through appropriate screening, follow-up care, and HPV vaccination.

For average-risk adults, commonly used U.S. screening recommendations include:

• Ages 21–29: A Pap test every three years under some guidelines.
• Ages 30–65: Depending on the guideline and available testing, options may include an HPV test every five years, a Pap test every three years, or both tests every five years.

Recommendations vary among medical organizations, and some guidelines now prioritize HPV testing beginning at age 25. Your personal schedule may also differ based on previous abnormal results, medical history, or other risk factors.

If you're unsure when you're due, checking your patient portal or asking your gynecologist or primary care clinician is a useful place to start.

This study raises important questions about cervical cancer screening trends in the United States, particularly how accurately we're measuring participation and whether certain groups face barriers to care.

But for your own health, the most useful takeaway is to know when you were last screened and when you're due again.

You may already be completely up to date, even if your last Pap smear was several years ago. Or you might discover that an appointment has slipped further down your calendar than you realized.