By Sara Bondell - August 09, 2020
You may notice some changes during your next visit to the OB-GYN thanks to revised cervical cancer screening guidelines from the American Cancer Society.
The new guidelines recommend human papillomavirus (HPV) primary testing—instead of a Pap test—every five years, starting at age 25 and continuing through 65. The previous guidelines released in 2012 advised screening to begin at age 21.
Less than 1% of cervical cancers are detected under age 25 and research shows screening women between ages 21 and 24 results in a high rate of overtreatment. The number of younger women with cervical cancer is decreasing thanks to HPV vaccination. According to the Centers for Disease Control and Prevention, infections with cancer and wart causing HPV strains have dropped 71% for young women.
A Pap test every three years is still considered an acceptable test for offices without access to HPV primary testing, but the guidelines recommend the Pap test be phased out once full access to primary HPV testing is available without barriers.
“In my view, these are simple, less complex guideline recommendations to improve adherence by both providers and patients,” said Dr. Hye Sook Chon, a gynecological oncologist at Moffitt Cancer Center.
A prospective U.S. screening study found switching from Pap tests to HPV testing prevented 13% more cervical cancer cases and 7% more cervical cancer deaths.
The U.S. Preventative Task Force and the American College of Obstetricians and Gynecologists recommendations currently differ from the ACS guidelines. Both groups encourage Pap tests every three years from ages 21 to 29, then co-testing with a Pap test and HPV primary test every five years from 30 to 65, or only a Pap test every three years.
Chon says it is still important to discuss your gynecological health with your provider.
“The ACS guidelines do not address screening or surveillance in individuals at higher risk for developing cervical cancer,” said Chon. “Moreover, access to primary HPV testing is limited in certain situations, so we have to individualize patient care in certain circumstances.”