HPV Vaccination Is Up. Cervical Cancer Screening Is Collapsing. Both Things Matter.
Among women aged 21 to 29, the share who have never had a cervical cancer screening rose from just above 12% in 2005 to nearly 32% in 2023, according to a JAMA Network Open analysis of around 106,000 women. Among women aged 30 to 65, the never-screened rate nearly tripled, reaching roughly 15% — about 9 million people.
Over the same period, HPV vaccination climbed from 6% to 54%. Researchers believe the two trends are connected: as vaccination became standard, a growing number of women concluded that the shot had made the Pap smear obsolete. It hasn’t.
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The HPV vaccine protects against the strains most likely to cause cervical cancer, but it doesn’t cover every strain — and it doesn’t help women who were already exposed before vaccination. For vaccinated women, screening intervals can be extended to every five years, but they cannot be skipped entirely. For unvaccinated or partially vaccinated women, regular screening remains the primary line of defense.
Current guidelines from the U.S. Preventive Services Task Force recommend cervical cancer screening every three years for women aged 21 to 65 using a Pap test, or every five years starting at 30 using a combination Pap and HPV co-test. The American Cancer Society recommends starting at 25, with primary HPV testing every five years as the preferred option. Those recommendations apply regardless of vaccination status. The vaccine changes the risk calculation; it doesn’t eliminate the need for a check.
Cervical cancer is one of the most preventable cancers when caught early — screening finds abnormal cells before they become cancer, often years in advance. The drop in screening rates, if it continues, will likely show up in cancer diagnoses within the decade. The message isn’t that vaccination failed. It’s that two tools working together do something neither does alone.