UPDATE: In March 2012, the U.S. Preventive Services Task Force (USPSTF) and the American Cancer Society (ACS) released final versions of their new recommendations on screening for cervical cancer. Although there were some differences in the draft recommendations of these two organizations, final guidelines are in agreement on these points:
- Women should begin cervical cancer screening at age 21.
- Women of average risk between the ages of 21 and 65 should have a Pap smear every 3 years or, for women 30 to 65, a Pap test and an HPV test every 5 years.
- Women over the age of 65 should discontinue screening if prior regular screenings have been normal and they are not at high risk for cervical cancer.
For the ACS, this represents a change from their previous recommendation that women be screened for cervical cancer with an annual Pap smear. Both organizations highlight in their recommendations that HPV testing should not be performed alone (without a Pap smear) and not in women under age 30 unless, the ACS states, a woman has an abnormal Pap test result.
Original article published November 2, 2011:
The U.S. Preventive Services Task Force (USPSTF) has released a draft recommendation statement that contains changes to its previous guidelines for cervical cancer screening. Following a review of evidence, it now recommends that:
- Women between the ages of 21 and 65 who have had vaginal intercourse have cervical cancer screening with a Pap smear every 3 years.
- Women younger than 21 do not have cervical cancer screening, regardless of sexual history.
- Women older than 65 do not have continued cervical cancer screening unless at high risk.
In terms of the method of testing, the Task Force is recommending against screening using human papillomavirus (HPV) testing, alone or in combination with Pap smear, in women under age 30. It also concluded that there is not enough evidence to determine the benefits versus the harms of HPV testing, alone or in combination with Pap smear, for women age 30 and older. The USPSTF hopes that these changes will reduce the number of unnecessary tests performed, which can lead to false positives, avoidable procedures and treatment, and undue anxiety. This recommendation statement is open for public comment until November 16.
In an effort to reduce confusion among patients and health care providers, the American Cancer Society (ACS), the American Society for Colposcopy and Cervical Pathology (ASCCP), and the American Society for Clinical Pathology (ASCP) released their proposed joint recommendations the same day as the USPSTF's. These organizations worked independently of the USPSTF to develop their new cervical cancer screening guidelines, but with the same aim of reducing the number of unnecessary tests performed while minimizing risks. The proposed guidelines are also currently open for public comment.
The joint recommendations are in agreement with most of those of the USPSTF. They plan to:
- Change their guidelines for women ages 21 to 65 to a 3-year frequency; however, in contrast to the USPSTF, they support screening with both the Pap and HPV test for women age 30 to 65.
- Drop the recommendation that women begin screening within 3 years of first vaginal intercourse, instead stating age 21 as the age at which to begin screening.
- Now recommend against screening for women 65 and older who have had three or more normal Pap smears in a row and no abnormal results in the past 10 years, or two or more negative HPV tests in the past 10 years.
It remains to be seen if other organizations, such as the American College of Obstetricians and Gynecologists (ACOG), will also change their guidelines as well.
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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.
Walsh, Nancy. Medical News: Pap Tests Needed Only Every 3 Years, Task Force Says. Medpage Today. October 19, 2011. Available online at http://www.medpagetoday.com/PrimaryCare/PreventiveCare/29132 through http://www.medpagetoday.com. Accessed October 2011.
U.S. Preventive Services Task Force. Draft Recommendation Statement (October 19 until November 16, 2011). Available online at http://www.uspreventiveservicestaskforce.org/draftrec4.htm through http://www.uspreventiveservicestaskforce.org. Accessed October 2011.
American Cancer Society. MediaRoom – Press Releases. Health Groups Issue Proposed Cervical Cancer Screening Guidelines. Available online at http://pressroom.cancer.org/index.php?s=43&item=333 thorugh http://pressroom.cancer.org. Accessed October 2011.
U.S. Preventive Services Task Force. Screening for Cervical Cancer. Release Date: March 2012. Available online at http://www.uspreventiveservicestaskforce.org/uspstf/uspscerv.htm through http://www.uspreventiveservicestaskforce.org. Accessed March 2012.
Moyer, VA on behalf of the U.S. Preventive Services Task Force. Screening for Cervical Cancer: U.S. Preventive Services Task Force Recommendation Statement. Annals of Internal Medicine, March 6, 2012, 156(5). Available online at http://www.annals.org/content/early/2012/03/14/0003-4819-156-12-201206190-00424.full through http://www.annals.org. Accessed March 2012.
American Cancer Society. New Screening Guidelines for Cervical Cancer. Article date: March 14, 2012. Available online at http://www.cancer.org/Cancer/news/News/new-screening-guidelines-for-cervical-cancer through http://www.cancer.org. Accessed March 2012.