New recommendations for screening for cervical cancer give women more options

The US Preventative Services Task Force (USPSTF) has issued new recommendations for screening for cervical cancer that offer women more testing options. The biggest change is for women aged 30-65 to be able to take no smears at all.

New evidence reveals that the human papillomavirus (HPV), a sexually transmitted disease, causes almost all cases of cervical cancer. Therefore, women aged 30-65 can now choose to do an HPV test once every five years to screen cervical cancer.

In the past, the recommendation for women in that age group was once every five years a smear, also called an exfoliative cytology, once every three years or a smear combined with an HPV test (co-testing). Women can still choose to use these options to screen cervical cancer.

This is the first time that people with cervixes have the ability to screen for cervical cancer only on an HPV test. These tests are recommended, regardless of sexual history.

For women aged 21-29, it is still recommended that a smear be performed once every three years. It is not recommended to not test women under the age of 21, as cervical cancer is rare before the age of 21 years. Cervical cancer is a slow-moving disease, and HPV infections can resolve themselves or fall back, making screening for cervical cancer before the age of 21 more harmful than beneficial, according to the USPSTF.

Likewise, women older than 65 who are sufficiently screened for cervical cancer do not need to be tested either. Those who are over 65 years of age and who have had 3 pap smears without irregular results or 2 co-tests without irregular results in the last 10 years no longer need to be screened for cervical cancer, even if they report having a new sexual partner.

These new guidelines only apply to people with a cervix who have had no irregular test results. People who have been diagnosed with a high-grade precancerous lesion or cervical cancer should consult their physicians to discuss their test options.

HPV can cause cell changes in the cervix, which can lead to cervical cancer. Deaths from cervical cancer have decreased considerably since the 1960s because of the widespread screening. In the US, cervical cancer is the 18th most common cause of cancer death, with 13,240 new cases and 4,170 deaths predicted in 2018. Most cases of death from cervical cancer occur in those who have not been adequately screened. Women in low-income communities, women of color and women living in remote or rural communities together form a larger population of these deaths from cervical cancer.


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