At what age is the Papanicolaou (Pap) test recommended to begin for cervical cancer screening?

The recommended age to begin cervical cancer screening with the Papanicolaou (Pap) test is 21 years. This guideline is informed by the understanding that cervical cancer is relatively rare in younger populations, and the natural history of HPV infection suggests that many young women will clear the virus without intervention. Starting screening at 21 helps to balance the benefits of early detection with the potential harms of unnecessary treatment for lesions that might resolve on their own.

The guidelines also reflect evidence that screening before this age does not significantly reduce the incidence of cervical cancer. As such, women are encouraged to begin Pap testing at age 21, regardless of sexual history, and to undergo screening every three years until the age of 29. From ages 30 to 65, screening can shift to every five years when combined with HPV testing.