I Have Received the HPV Vaccine. Do I Still Need Cervical Cancer Screening?

Medical Writer: Rachel Njuguna, Dip (Medical Laboratory Science)

Medical Reviewer: Azuka Chinweokwu Ezeike, MBBS, FWACS, FMCOG, MSc (PH)

Highlights

• HPV causes most cases of cervical cancer, but vaccination does not protect against every cancer-causing HPV type.
• The HPV vaccine prevents new infections but does not treat HPV infections acquired before vaccination.
• HPV-vaccinated individuals still need cervical cancer screening because some cancer-causing HPV infections can occur despite vaccination.
• Screening detects high-risk HPV infections and early cervical cell changes before they develop into cancer.
• Following recommended screening intervals and attending follow-up appointments helps prevent cervical cancer.

Introduction

Getting the HPV vaccine is an important step towards preventing cervical cancer. But does vaccination mean you can skip screening?In 2022, an estimated 660,000 women were diagnosed with cervical cancer worldwide, and approximately 350,000 died from the disease. Nearly 94% of these deaths occurred in low- and middle-income countries, highlighting inequalities in access to prevention, screening, and treatment.

Human papillomavirus (HPV) is a common virus that can infect the skin and moist linings of the body, such as the cervix, genital region, and throat.  Certain types of HPV can cause cervical cancer, making vaccination an important tool for preventing the disease. However, a common misconception is that receiving the HPV vaccine eliminates the need for cervical cancer screening.

Understanding how HPV vaccination and cervical cancer screening work together can help you make informed decisions about protecting your cervical health.

What Is HPV and How Does It Cause Cervical Cancer?

Human papillomavirus (HPV) is not a single virus but a large group of related viruses, with different types affecting different parts of the body. Some types cause common warts or genital warts, while others can infect cervical cells. These differences matter because not all HPV types carry the same risk of cancer [1].HPV types are broadly classified as :

• Low-risk HPV 
• High-risk HPV

This is based on their potential to cause cancer. Low-risk types, such as HPV 6 and 11, are mainly associated with genital warts. High-risk types, particularly HPV 16 and 18, can cause changes in cervical cells that may eventually lead to cancer. However, having a high-risk HPV infection does not mean that someone has cancer or will inevitably develop it [1,2].

In most cases, the body's immune system controls or clears an HPV infection naturally. The concern arises when a high-risk infection persists for years. The virus can interfere with the normal processes that regulate how infected cells grow and divide. This can lead to abnormal changes in cervical cells, which may develop into precancerous lesions. If these lesions are not detected and treated, some can progress to cervical cancer over time [1,2].

This progression usually takes many years, which creates an opportunity to detect and treat precancerous changes before they become cancerous. Understanding this process also helps explain why preventing high-risk HPV infections and detecting abnormal cervical changes are both important parts of cervical cancer prevention.

What Does the HPV Vaccine Protect Against? 

HPV vaccines protect against specific types of human papillomavirus that cause cervical cancer and other HPV-related cancers, including cancers of the vagina, vulva, penis, anus, and oropharynx. Depending on the vaccine, they can also protect against HPV types that cause genital warts. The protection offered depends on which vaccine a person receives. 

There are six licensed HPV vaccine products, grouped into three categories: 

• Bivalent, 
• Quadrivalent and
• Nonavalent vaccines. 

These names refer to how many HPV types each vaccine targets. Although all three categories protect against HPV types 16 and 18, which together cause approximately 70% of cervical cancer cases worldwide, they differ in whether they also protect against other HPV types.

• Bivalent vaccines: These target HPV types 16 and 18. They help prevent infections caused by these two high-risk types but do not directly target HPV types 6 and 11, which cause most genital warts [3,4].
• Quadrivalent vaccines: These vaccines are recombinant injections that protect against four strains of human papillomavirus: high-risk types 16 and 18 (which cause most cervical, vulvar, vaginal, and anal cancers) and low-risk types 6 and 11 (which cause roughly 90% of genital warts) [4,5].  
• Nonavalent vaccines: These protect against nine types of HPV: low-risk types 6 and 11 (which cause most genital warts) and high-risk types 16, 18, 31, 33, 45, 52, and 58 (which cause most HPV-related cancers and precancerous lesions).  By covering five additional high-risk types beyond those targeted by quadrivalent vaccines, they provide broader protection against HPV types associated with cervical cancer [4].

The main difference between these categories is the range of HPV types they cover. Broader coverage does not mean that every HPV type capable of causing cancer is included. Therefore, though HPV vaccination greatly reduces the risk of cervical cancer, it does not eliminate that risk [5].

HPV vaccination is routinely recommended for children aged 9–14 years, before they become sexually active and are exposed to the virus. Importantly, the vaccine prevents new infections; it does not treat an existing HPV infection or remove precancerous cervical cell changes that have already developed [3].

 If I Have Had the HPV Vaccine, Do I Still Need Screening? 

Yes. Receiving the HPV vaccine does not mean you can skip cervical cancer screening. Vaccination substantially reduces your risk of developing cervical cancer, but it does not eliminate that risk. The World Health Organization (WHO) recommends that vaccinated women continue to attend cervical cancer screening according to the recommendations in their country.

There are several reasons why screening remains important, even if you have been vaccinated.

1. The vaccine does not protect against every cancer-causing HPV type

HPV vaccines protect against specific types of the virus associated with cervical cancer. However, other high-risk HPV types can still infect cervical cells and cause changes that may eventually develop into cancer. Even the nonavalent vaccine, which covers nine HPV types, does not cover every HPV type associated with cervical cancer [6]. This means that vaccination greatly reduces the risk of cervical cancer but cannot prevent every case.

2. The vaccine does not treat an infection you already have

HPV vaccines are preventive: they help protect against new infections caused by the HPV types they target. They do not clear an existing HPV infection or treat abnormal cervical cells that have already developed.For example, if someone receives the vaccine after acquiring a high-risk HPV infection, the vaccine will not treat that existing infection. The person may still benefit from protection against other HPV types included in the vaccine that they have not acquired [3,6]. 

3. Not everyone receives the same protection from vaccination

The level of protection depends on the vaccine received, as different vaccines target different HPV types. Protection may also vary according to a person's immune status and whether they completed the vaccination schedule recommended for their age and circumstances. However, even with vaccination, screening remains important because no HPV vaccine protects against every cancer-causing HPV type [3]. 

How Does Cervical Cancer Screening Help?

Cervical cancer screening looks for high-risk HPV infections or abnormal cervical cell changes that could develop into cancer. Depending on the screening programme, this may involve an HPV test or cervical cytology, commonly known as a Pap smear test.

Persistent high-risk HPV infections can cause precancerous changes over time. Screening can identify these changes so that they can be assessed and, when necessary, treated before they progress to cancer. It is an important part of cervical cancer prevention, including for women who have been vaccinated [6].

Vaccination Works Best When Combined with Screening

Vaccination helps prevent HPV infections that can lead to cervical cancer, while screening checks for high-risk HPV or early changes in cervical cells. Both are important steps in protecting your health. Even if you have received the HPV vaccine, do not skip cervical cancer screening. Follow the screening recommendations where you live

 When Should I Start Cervical Cancer Screening?

When you should start depends on your age, your risk factors, and the screening guidelines followed in your country.

1. General Screening Guidelines (Average Risk)

For people at average risk, the recommended starting age varies between screening guidelines.

• Starting at age 21: The American College of Obstetricians and Gynecologists (ACOG) cervical cancer screening guidelines advise a Pap test every three years for people aged 21–29.
• Starting at age 25: The American Cancer Society's cervical cancer screening guidelines recommend starting at age 25, with a primary HPV test every five years.
• WHO recommendation: The WHO cervical screening guideline recommends starting at age 30 for the general population and age 25 for women living with HIV, using HPV DNA testing. 
• Ages 30–65: The 2026 cervical cancer screening guidelines recommend a primary HPV test every five years as the preferred option. Co-testing every five years or a Pap test every three years may be alternatives when primary HPV testing is unavailable or after counselling. 

Why Not Start Earlier?

Routine cervical cancer screening is generally not recommended before age 21. HPV infections are common in younger people, but many clear naturally within one to two years. If cervical cell changes occur, they often return to normal without treatment. Screening too early can lead to unnecessary follow-up tests and treatment, even for changes that might resolve on their own.

2. Screening Guidelines for Women Living with HIV

Women living with HIV have a higher risk of persistent HPV infection and cervical cancer. They therefore need screening that takes their increased risk into account.

• When to start: Screening is recommended from age 25 in the WHO guideline for women living with HIV [7]. 
• How often to screen: When HPV DNA testing is used, screening is recommended every 3–5 years. Other testing methods may require different intervals [7]
• How long to continue: Screening may need to continue beyond age 65, depending on the person's health, previous results, and the guidelines followed in their country.

These recommendations are not identical worldwide. The appropriate starting age and screening interval depend on the screening programme and the test used. Receiving the HPV vaccine does not remove the need for screening.

Conclusion

The HPV vaccine has significantly reduced the risk of cervical cancer, but vaccination alone cannot prevent every case. Regular cervical cancer screening remains an important part of protecting your health because it can detect high-risk HPV infections and early cell changes before they develop into cancer.

Knowing when to start screening, attending appointments at the recommended intervals, and following up on abnormal results can make a meaningful difference to your long-term health. If you have received the HPV vaccine, continue screening as recommended. If you have not been vaccinated, screening is still important, and you can speak to a healthcare professional about whether vaccination may benefit you.Taking both steps, vaccination and appropriate screening, offers stronger protection against cervical cancer.

Frequently Asked Questions (FAQs)

1. Can I get cervical cancer after receiving the HPV vaccine?

Yes. The vaccine greatly reduces your risk but does not prevent every case of cervical cancer.

2. Do I still need cervical cancer screening if I have been vaccinated?

Yes. You should continue screening according to the recommendations for your age and health circumstances.

3. Can I skip screening if I have only had one sexual partner?

No. Having one sexual partner does not eliminate your risk of HPV infection.

4. Does a positive HPV test mean I have cervical cancer?

No. It means high-risk HPV has been detected. Further testing may be needed to check for abnormal cervical cell changes.

5. Do I need cervical cancer screening if I have no symptoms?

Yes. HPV infections and early cervical cell changes often cause no symptoms, so routine screening remains important.

References

1. Della Fera AN, Warburton A, Coursey TL, Khurana S, McBride AA. Persistent human papillomavirus infection. Viruses. 2021;13(2):321. Available from: https://doi.org/10.3390/v13020321
2. Ye J, Zheng L, He Y, Qi X. Human papillomavirus-associated cervical lesion: pathogenesis and therapeutic interventions. MedComm. 2023;4(5):e368. Available from: https://doi.org/10.1002/mco2.368
3. Arbyn M, Xu L, Simoens C, Martin-Hirsch PP. Prophylactic vaccination against human papillomaviruses to prevent cervical cancer and its precursors. Cochrane Database Syst Rev. 2018;5(5):CD009069. Available from: https://doi.org/10.1002/14651858.CD009069.pub3
4. Kim J, Choe YJ, Park J, Cho J, Cheong C, Oh JK, et al. Comparative effects of bivalent, quadrivalent, and nonavalent human papillomavirus vaccines in the prevention of genotype-specific infection: a systematic review and network meta-analysis. Infect Chemother. 2024;56(1):37–46. Available from: https://doi.org/10.3947/ic.2023.0064
5. Brown DR, Joura EA, Yen GP, Kothari S, Luxembourg A, Saah A, et al. Systematic literature review of cross-protective effect of HPV vaccines based on data from randomized clinical trials and real-world evidence. Vaccine. 2021;39(16):2224–36. Available from: https://doi.org/10.1016/j.vaccine.2020.11.076
6. Kyrgiou M, Arbyn M, Bergeron C, Bosch FX, Dillner J, Jit M, et al. Cervical screening: ESGO-EFC position paper of the European Society of Gynaecologic Oncology (ESGO) and the European Federation of Colposcopy (EFC). Br J Cancer. 2020;123(4):510–7. Available from: https://doi.org/10.1038/s41416-020-0920-9
7. Harlfinger J, Sommer I, Gartlehner G. [WHO guideline for screening and treatment of cervical pre-cancerous lesions for cervical cancer prevention (second edition)]. Gesundheitswesen. 2023;85(7):630–4. German. Available from: https://doi.org/10.1055/a-2052-6652

Disclaimer:
The information provided on this website is for general educational and informational purposes only. It is not intended to replace professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Published October 21, 2026