By Prof Nóirín Russell, Clinical Director, CervicalCheck
New European guidelines on cervical screening have been published by the European Commission Initiative on Cervical Cancer (EC-CvC). The guidelines are about when to start cervical screening and how often to screen for people who had the HPV vaccine when they were younger.
The work of the EC-CvC Expert Working Group is led by scientists from the World Health Organization’s International Agency for Research on Cancer (IARC).
What’s new
For the first time, the guidelines take account of HPV vaccination and suggest different screening approaches based on risk.
The HPV vaccine significantly lowers the risk of cervical cancer and means fewer abnormal cell changes. Because of this, it is safe and effective for screening to happen less often for some people.
The guidelines depend on:
- how many people in the eligible population were vaccinated (vaccination coverage)
- how common HPV16 was before vaccination (HPV16 prevalence).
There are more than 100 types of HPV (the human papillomavirus). HPV16 is a high-risk subtype that causes most cases of cervical cancer.
What is recommended
- If 75% or more of the eligible population are vaccinated against HPV:
- start screening at age 30
- screen every 10 years (if results are HPV not found).
This applies regardless of how common HPV16 was before vaccination.
2. If between 50% to 74% of people are vaccinated against HPV:
- start screening at age 30 and screen every 10 years if HPV16 levels were low before vaccination
- start screening at age 25 and screen every 10 years if HPV16 levels were high before vaccination.
3. If less than 50% of people are vaccinated against HPV:
- there are no changes recommended in these settings and screening should stay the same as for people who are not vaccinated.
Why this matters
HPV vaccination changes the level of risk of cervical cancer and the guidelines suggest that screening should adapt to that lower risk. The advice is based on research that looked at many possible screening approaches.
It found that:
- screening every 5 years in highly vaccinated groups does not add much benefit
- screening every 10 years works just as well
- screening less often can reduce unnecessary referrals to colposcopy and unnecessary treatment.
The guidelines are an important step towards:
- more personalised screening based on risk
- reducing unnecessary tests and treatment
- making screening programmes more efficient and cost-effective.
What’s next
We continue to look at emerging evidence to improve outcomes for women who choose screening and to ensure that we are applying best international practice in our CervicalCheck programme.
As new evidence becomes available, we will present it to the National Screening Advisory Committee for further review. This Committee is an independent body which makes recommendations to the Department of Health on new screening programmes, or changes to existing screening programmes in Ireland.
This is the second set of guidelines published by the EC-CvC. In 2025, the group published recommendations on the primary screening method for cervical screening and what ages to start and stop cervical screening.
The group has also started work to draft recommendations on:
- future screening intervals in women who test negative for HPV
- appropriate triage tests for women who test positive for HPV to assist with deciding who needs onward referral for colposcopy and who can be reassured that their risk of cervical cancer is low.
The EC-CvC initiative aims to improve cervical cancer prevention and care across Europe. It brings countries together to use strong evidence and focus on patient needs. By setting shared standards for quality care across Europe, the initiative aims to:
- reduce differences in care between countries
- improve people’s experience of screening
- support earlier diagnosis and better outcomes.
By mid-2026, it will provide clear, evidence-based guidance on the full pathway of care – from HPV vaccination and screening to diagnosis, treatment and end-of-life care.
The completion of the guidelines supports the global goal of eliminating cervical cancer.