New cervical cancer guidlines have recently been released.
American Cancer Society, American Society for Colposcopy
and Cervical Pathology, and American Society for Clinical
Pathology screening guidelines for the prevention and early
detection of cervical cancer. The following is a summary
of the scientis'ts key recommendations:
•Cervical cancer screening should begin at age 21.
•Women 21 to 29 years old should be screened with
Pap test alone every three years.
•Women 30 to 65 years old should be screened with
Pap and HPV tests (co-testing) every five years (preferred)
or with Pap test every three years (acceptable).
•Women who co-test HPV positive but cytology negative
should be followed with either (1) repeat co-testing within
12 months or (2) immediate HPV genotype-specific testing
for HPV 16 alone or for HPV 16 and HPV 18. If co-testing
is repeated at 12 months, women testing positive on either
test should be referred to colposcopy; women testing negative
on both tests should return to routine screening.
•In most clinical settings, women ages 30 to 65 years
old should not be screened with HPV testing alone as an
alternative to co-testing at five-year intervals or Pap
test alone at three-year intervals.
•Women at age 65 with adequate negative screening
in the last 10 years and no history of cancer may stop screening.
•Women at any age following a hysterectomy with removal
of the cervix who have no history of CIN2+ should not be
screened for vaginal cancer using any modality.
•Recommended screening practices should not change
on the basis of HPV vaccination status.