At what age should cervical cancer screening begin?

• A. 25
• B. 21
• C. 30
• D. 18

Answer: (B)

Starting cervical cancer screening at age 21 reflects the balance between early detection and avoiding harm from overdiagnosis in adolescents. In teens, HPV infections are very common and most clear on their own within a few years, so screening before 21 yields many false positives and unnecessary procedures without reducing cancer risk. Beginning at 21 allows you to detect precancerous changes when they’re more likely to be clinically meaningful, while minimizing interventions in those who would likely clear the infection spontaneously.

Typically, screening from 21–29 is with Pap cytology every 3 years. From 30–65, you have the option of Pap plus HPV testing every 5 years (co-testing) or Pap alone every 3 years, depending on guidelines used.