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Cervical Screening Guidelines Summary

This information also available as a PDF download.

Screening Initiation

Women should begin cervical screening at age 21 if they are or have ever been sexually active. Women who are not sexually active by age 21 should delay cervical screening until they are sexually active. Sexual activity includes intercourse, as well as digital or oral sexual activity involving the genital area with a partner of either sex.

Screening Interval

If a woman’s cytology is normal, she should be screened every 3 years. The absence of transformation zone is not a reason to repeat a Pap test earlier than the recommended interval. For more information, go to Recommendations for Follow-Up of Abnormal Cytology.

Screening Cessation

A woman may discontinue screening at age 70 if she has an adequate and negative cytology screening history in the previous 10 years (i.e., 3 or more negative cytology tests).

Notes:

  • Any visible cervical abnormalities or abnormal symptoms must be investigated by a specialist (e.g., colposcopist, gyne-oncologist, gynecologist) regardless of cytology findings.
  • We are working with the Ministry of Health and Long-Term Care to implement HPV testing in the Ontario Cervical Screening Program.

Qualifying Statement

Women who are not sexually active by age 21 should delay cervical cancer screening until sexually active.

Special Screening Circumstances

  • Women who have sex with women should follow the same cervical screening regimen as women who have sex with men.
  • Pregnant women should be screened according to the guidelines. Pregnancy does not alter the recommended screening interval. Only conduct Pap tests during pre- and post-natal care if a woman is due for regular screening.
  • Women who have undergone subtotal hysterectomy and retained their cervix should continue screening according to the guidelines.
  • Women who are immunocompromised (e.g., HIV-positive or on long-term immunosuppressants) should receive annual screening.
  • Transgender men who have retained their cervix should be screened according to the guidelines.