Cervical cancer: more careful screening for immunocompromised women

A higher risk for women with a weakened immune system

In France, approximately 3,000 new cases of cervical cancer are diagnosed every year. In the vast majority of cases, This cancer is caused by a persistent human papillomavirus (HPV) infection.

However, when the immune system is weakened (due to a transplant, autoimmune disease, or immunosuppressant treatment), the body eliminates this virus less well. As a result, precancerous lesions are more likely to progress.

Until now, only women living with HIV were subject to specific recommendations. But the HAS has just extended this vigilance to other forms of immunosuppression, finding that the risk of developing cervical cancer is “significantly increased” in these patients.

Who is affected by these new recommendations?

The recommendations published on October 2, 2025 address different categories of people:

• those with primary or congenital immunodeficiency (such as Di George syndrome or hypogammaglobulinemia);
• people transplanted with allogeneic hematopoietic stem cells ;
• women with systemic lupuswhether they are treated or not;
• those on immunosuppressive treatment for at least one yearfor a transplant, inflammatory bowel disease, rheumatoid arthritis, or multiple sclerosis;
• and more generally, any person diagnosed with severe immunosuppression.

For these patients, screening should begin within one year of diagnosis or initiation of treatment. Even if a previous HPV test was negative, it is advisable to resume careful monitoring.

A tight screening program

Concretely, the HAS recommends:

• from 25 to 29 years old : a smear (cytology) every year,
• from 30 to 65 years : one HPV test every 3 years,
• over 65 years old : whether or not to continue screening will be decided on a case-by-case basis, based on the medical history.

The sampling can be carried out, as for the general population, by a gynaecologist, a midwife or a general practitioner. Independent withdrawal is also possible from the age of 30, in particular for women with reduced mobility.

Prevention rather than cure: the importance of vaccination and monitoring

HAS underlines this HPV vaccination remains the first line of prevention. It is recommended from the age of 11, for girls and boys, and as a recovery up to 26 years of age. But this vaccination does not protect against all types of viruses and does not replace regular screening.

For immunocompromised women, this regular monitoring not only allows for early detection of abnormalities but also strengthens the bond with healthcare providers. An important challenge when the immune system is put to the test by disease or treatment.

A question of fairness and information

These new recommendations also pose a practical challenge: identify affected patients send them invitations to screenings in a timely manner.

HAS therefore underlines the need for clear tools for healthcare professionals and a targeted information campaign. Because, as with the general population, the effectiveness of screening depends above all on the participation of the women concerned.

Source: Madmoizelle