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Cervical Screening at Age 25

  • Ontario Health (Cancer Care Ontario) is encouraging primary care providers to start cervical screening for patients at age 25 based on moderate quality evidence suggesting that people under age 25 do not benefit from cervical screening.
  • In fact, screening people before age 25 may do more harm than benefit.
  • Early cervical cell changes are likely to resolve on their own in people under age 25. Even if the cell changes do not resolve, they are unlikely to become cancer before someone is screened for the first time because cervical cancer takes several years to develop.
  • Cervical cancer is extremely rare in people under age 25. For example, in 2017, there were no new cases of cervical cancer in people younger than 25 in Ontario. Therefore, screening people under 25 may result in follow-up tests and treatments that do not benefit them.
  • Many screening programs recommend starting cervical screening at age 25 or later, including those in British Columbia, Alberta and Nova Scotia in Canada, and other countries internationally.
  • The Ontario Cervical Screening Program will formally change the age of initiation for cervical screening from 21 to 25 with the implementation of human papillomavirus (HPV) testing in the program. Until the change is formally implemented, we will continue to encourage primary care providers to consider delaying screening until age 25. Reasons include the impact of COVID-19 on healthcare services, and the limited benefit and potential harms of screening in younger people.
  • Investigate any visible cervical abnormalities or abnormal symptoms regardless of the patient’s age. Consider referral to a specialist (e.g., colposcopist, gynecologist, gyne-oncologist) as appropriate.

Find cervical screening resources from the Ontario Cervical Screening Program.