<h3>Objectives:</h3> United States Preventive Services Task Force (USPSTF) screening guidelines are widely used to establish standards of care. There are gaps, however, in the study populations on which the 2018 USPSTF cervical cancer screening guidelines are based. The purpose of this study is to: 1) conduct a systematic review of the studies that comprise these guidelines, focusing on high risk United States (US) populations as defined by self-identified race or ethnicity, age ≥65, and insurance status, 2) analyze the generalizability of the guidelines to high risk US populations. <h3>Methods:</h3> We accessed the USPSTF 2018 Cervical Cancer screening guidelines and the evidence summary and reviewed the seven randomized control trials (RCTs), four cohort studies, and one cross-sectional analysis that provided the evidence for these recommendations. We identified demographic data specific to self-identified race or ethnicity, age ≥65, and insurance status. Additionally, we reviewed the latest cervical cancer screening guidelines published by the National Comprehensive Cancer Network (NCCN), American Society for Colposcopy & Cervical Pathology (ASCCP), American College of Obstetrics & Gynecology (ACOG), American Society for Clinical Pathology (ASCP), and the American Cancer Society (ACS). Finally, in August 2020, we searched PubMed for RCTs, meta-analyses, clinical trials, systematic reviews from 2015-2020, focusing on our pre-identified demographic data. <h3>Results:</h3> Two of the 14 studies used as the basis for the 2018 USPSTF cervical cancer screening include race or ethnicity data (Table 1). Of these two studies, one was a US-based cohort study and the other a cross-sectional study from the United Kingdom (Table 1). None of the RCTs used for the USPSTF guidelines included race or ethnicity. All seven RCTs were conducted in countries with less racial diversity than the US, except for Canada (Table 1). Four studies included participants age ≥65. Eleven of the 14 studies were conducted in countries with some form of universal health care coverage. Of the non-USP-STF organizations, the 2019 ASCCP guidelines used three cohorts that included majority White participants, low-income patients, and individuals age ≥65. Of the 629 PubMed articles reviewed, 18 studies suggested that the application of current cervical cancer screening guidelines to high risk populations may lead to underscreening and delay in diagnosis. <h3>Conclusions:</h3> While the screening guidelines from USPSTF and non-USPSTF organizations discuss the existence of broad disparities in cervical cancer screening, few of the studies used to comprise these guidelines specifically include high risk populations in the US as defined by self-identified race or ethnicity, age ≥65, insurance status. In addition, the generalizability of these guidelines to a US population remains limited given the participant demographics enrolled in the studies that comprise these guidelines.