Over the past 60 years, cervical cancer mortality has declined by 70% in the U.S. As a result of more successful cervical cancer screening programs, in 1995, the American College of Obstetricians and Gynecologists (ACOG) recommended a new cervical cancer screening protocol with Pap smears and pelvic exams beginning after sexual debut or at age 18 years, with one-year intervals between screenings. Although the Pap smear method has the drawbacks of higher specificity and lower sensitivity, however, abnormal cytology misses can be compensated by annual screening. In 2002 and 2003, the American College of Obstetrics and Gynecology, the American Cancer Society, and the U.S. Preventive Services Task Force all introduced their own screening programs. In 2006, the American Society for Colposcopy and Cervical Pathology also introduced a screening program, and Pap smears combined with HPV-DNA testing were approved for use by the U.S. Food and Drug Administration and are performed annually. Between 2009-2011, the American Society for Clinical Pathology reconvened an expert panel and evaluated the evidence to introduce a new protocol. There are a number of different perspectives and controversies here. Many perspectives used some of the evidence to implement a high-quality cervical cancer prevention program, and of course there were concerns about cost. Cervical cancer is rare until the age of 20, and there is no significant increase in the incidence of cervical cancer until the age of 25 or 30. Patients with cancer detected by screening tend to have early lesions and therefore the vast majority are curable. In 2009, the ACOG still proposed an age for cervical cancer screening within 3 years of first sexual intercourse, with the first screening no later than 21 years of age. Studies have shown that the interval between Pap smears can be extended to three years for women after 30 years of age with good prior cytology. While the optimal interval for women between the ages of 20 and 30 years needs to be studied, given the lower sensitivity of Pap smears, the minimum standard for an extended screening interval is two consecutive normal cytology results. All evidence suggests that HPV testing is not meaningful in adolescents, and for women between the ages of 21-30 years, HPV surveillance may be considered for reference if atypical cells are found on Pap smear. It is recommended that the same criteria be applied for HPV surveillance in women 30 years of age and older. The U.S. Prevention Task Force, American College of Obstetricians and Gynecologists, agrees that for women 30 years of age and older, it is reasonable to use a regimen of Pap smears at three-year intervals. However, for patients with previous abnormal Pap cytology, impaired immune function, or poor compliance with three-year screening, HPV surveillance may be considered in these cases, or Pap cytology surveillance may be shortened to once every year. For low-risk women with no prior cancer or precancerous lesions who are on a formal screening regimen, the benefit of additional screening is less, and the USPSTF, ASCCP, and ACS recommend 65 years as the age of termination of screening. The risk of cervical cancer is 2-3 times greater in patients with high cervical intraepithelial neoplasia, but mortality from cervical cancer is lower because many cancer patients are diagnosed early, and we have no prospective evidence that increasing the frequency of screening improves the detection of patients with early-stage cancer. Considering that the morbidity and mortality rates are already relatively low with today’s protocols, all screening protocols recommend at least 20 years of follow-up for patients with high cervical intraepithelial neoplasia. Incidence of cervical cancer and mortality rates can be reduced by increasing the frequency of screening in previously unscreened populations.