NEW ACOG Cervical Cancer Screening Info

Summary

Dr. Chapa’s OBGYN Clinical Pearls

Episode: NEW ACOG Cervical Cancer Screening Info

Date: April 27, 2026
Host: Dr. Chapa

Brief Overview

In this episode, Dr. Chapa breaks down the major updates in the American College of Obstetricians and Gynecologists (ACOG) cervical cancer screening guidelines released in April 2026. The information is tailored to be clear, relevant, and immediately applicable for medical students, residents, and healthcare professionals. Dr. Chapa emphasizes the move towards primary high risk HPV testing, highlights specific age-based recommendations, and explains differences compared to previous guidelines and other organizations.

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Key Discussion Points and Insights

1. Background: Evolution of Screening Modalities

• Cervical cancer screening has shifted from being primarily cytology (Pap test) based to favoring a primary high risk HPV evaluation.
• This trend is reflected in the just-released (April 24, 2026) ACOG guideline updates.
  • Quote:

    “It was once primarily cytology based, but of course as we've mentioned on the show, there has been a huge trend towards primary high risk HPV evaluation. And that is where ACOG has landed in its most recent...recommendations.” — Dr. Chapa [00:12]

2. Screening Recommendations by Age Group

• Ages 21–29:

  • Cytology alone every three years remains the standard.
  • Notably diverges from the American Cancer Society (ACS), which starts HPV testing at 25.
  • Reasoning: Health equity and facilitating entry into the healthcare system.
    • Quote:

      “But ACOG as a point of health equity and entry into the healthcare system still recommends between 21 and the age of 29 cytology alone for every three years.” — Dr. Chapa [00:39]

• Ages 30–65:

  • Primary high risk HPV testing (clinician collected) every five years is now the first-line approach.

    • Must use an FDA-cleared test.
    • Quote:

      “Starting at the age of 30 up to 65, primary high risk HPV is now the first line offering as long as this clinician collected; that can be done every five years with an appropriate FDA cleared option.” — Dr. Chapa [00:56]

  • If primary HPV testing is unavailable:

    • Co-testing (HPV + cytology) every five years is still acceptable.

  • Patient-collected (self-collected) high risk HPV:

    • Now recommended as an option starting at age 30.
    • Interval: Every three years, instead of five.
    • Key detail:

      “For patient collection that screening interval should be every three years.” — Dr. Chapa [01:39]

3. Summary Table of Recommendations

| Age Group | Screening Modality | Interval | |------------|------------------------------------------------|------------------| | 21–29 | Cytology alone | Every 3 years | | 30–65 | Primary high risk HPV (clinician collected) | Every 5 years | | 30–65 | Co-testing (HPV + cytology) | Every 5 years | | 30–65 | Patient-collected high risk HPV | Every 3 years |

• Cytology has not been fully eliminated, as it remains the basic test in younger women.
  • Quote:

    “So cytology unfortunately has not completely gone away because it's still a thing between 21 and 29, at least according to the college.” — Dr. Chapa [01:53]

4. Practical Points and Clinical Pearls

• FDA clearance and proper collection method are emphasized for HPV tests.
• Flexibility built in for practices lacking access to newer or clinician-collected HPV tests: co-testing and patient self-collected options are allowed.
• Transition to HPV-centric screening aligns with global evidence and positive trial data.

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Notable Quotes and Memorable Moments

• Introduction of Guideline Changes:

  “Here's what the main changes include…” — Dr. Chapa [00:19]

• On Health Equity and System Entry:

  “As a point of health equity and entry into the healthcare system still recommends between 21 and the age of 29 cytology alone for every three years.” — Dr. Chapa [00:39]

• Highlighting Patient-Collected Testing Option:

  “…for patient collection that screening interval should be every three years.” — Dr. Chapa [01:39]

• Big Picture Summary:

  “But now primary high risk HPV is the screening modality of first choice according to ACOG between 30 and 65; make sure it's FDA approved, make sure it's clinician collected if available to you. If not, patient collect it can be done every three years or co-test…every five years in the age range of 30 to 65.” — Dr. Chapa [01:55]

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Key Timestamps

• Main Recommendations & Rationale: [00:01–01:55]
  • Divergence from ACS [00:29]
  • HPV self-collection option [01:26]
  • Summary and Clinical Application [01:53–01:55]

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Conclusion

Dr. Chapa provides a succinct but comprehensive breakdown of the new 2026 ACOG cervical cancer screening recommendations. The episode emphasizes that while cytology maintains its importance in younger women (ages 21–29), for ages 30–65, the focus firmly shifts to primary high risk HPV testing, with flexible options depending on local resources. This major update reflects the latest evidence and prioritizes both efficacy and access. Dr. Chapa’s engaging, clear style makes complex updates digestible and directly useful for clinical care.

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For further reading: Refer to ACOG’s published April 2026 guidelines on cervical cancer screening.

Transcript

[A]

Well, if you follow our podcast, you know that we've been reporting on and following the ever evolving saga of cervical cancer screening. It was once primarily cytology based, but of course as we've mentioned on the show, there has been a huge trend towards primary high risk HPV evaluation. And that is where ACOG has landed in its most recent end of April 2026 cervical cancer screening recommendations. This just came out on April 24, slide 25 because one was a press release. But here's what the main changes include. Of course they still recommend the 21 to 29 age frame for primary cytology every three years, which is different than the American Cancer Society which recommends checking primary high risk HPV starting at the age of 25. But ACOG as a point of of health equity and entry into the healthcare system still recommends between 21 and the age of 29 cytology alone for every three years. However, here's the big change. Starting at the age of 30 up to 65, primary high risk HPV is now the first line offering as long as this clinician collected that can be done every five years with an appropriate FDA cleared option. All right, so 30 to 65 it is clinician collected primary high risk HPV every five years. In places that don't have that, then co testing with HPV and cytology can still continue like people are doing now every five years in that same time span. Now here's the catch for those that want patient collected high risk HPV that is also now in the recommendation that's fine starting at the age of 30. But ACOG makes the distinction here that for patient collection that screening interval should be every three years. So between 30 and 65 it is either clinician collected primary high risk HPV every five years or co testing when that's not available again every five years or patients self collected every three years in that same time frame. So cytology unfortunately has not completely gone away because it's still a thing between 21 and 29, at least according to the college. But now primary high risk HPV is the screening modality of first choice according to ACOG between 30 and 65, make sure it's FDA approved, make sure it's clinician collected if available to you. If not patient collect it can be done every three years or co test between the same time interval of every five years in the age range of 30 to 65.

[B]

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