Screening

New Guidelines for Cervical Cancer Screening

A new set of guidelines for cervical cancer screening in average-risk women (21 years or older) was recently released by the American College of Physicians.

“Recent evidence-based guidelines for screening have refined the approach in an effort to minimize harms and maximize benefits,” said the study’s authors.

“In general, the approach has focused on increasing the age at which to begin screening, lengthening the screening interval, and discontinuing screening in women at low risk for future cervical cancer. Overuse of screening contributes to higher health care costs without improving patient outcomes,” they said.

Some of the recommendations included within the guidelines were:

  • Average-risk women under the age of 21 years should not be screened for cervical cancer.
  • Once average-risk women reach the age of 21 years they should be screened (once every 3 years) with cytology.
  • Average-risk women should not be screened with cytology more frequent than every 3 years.
  • Average-risk women aged 30 years or older—who prefer screening less often than every 3 years—should undergo cytology and HPV testing once every 5 years.
  • Average-risk women younger than 30 years should not have HPV testing performed.
  • Average-risk women older than 65 years should not continue being screened for cervical cancer if they had 3 consecutive, negative cytology results or 2 consecutive, negative cytology with HPV test results within a 10-year period—the most recent test performed within 5 years.
  • Average-risk women of any age should not be screened for cervical cancer if they had a hysterectomy with removal of the cervix.

The recommendations were endorsed by the American Society for Clinical Pathology and supported by the American Congress of Obstetricians and Gynecologists.

The complete guidelines are published in the April issue of Annals of Internal Medicine.

-Michelle Canales Butcher

Reference:

Sawaya GF, Kulasingam S, Denberg T, Qaseem A. Cervical cancer screening in average-risk women: best practice advice from the clinical guidelines committee of the American College of Physicians. Ann Intern Med. 2015 April [epub ahead of print] doi: 10.7326/M14-2426.