According to updated recommendations from the US Preventive Services Task Force, options for cervical cancer screening include a Pap test every three years for women between the ages of 21 and 65, or—for women between the ages of 30 and 65—a Pap test plus an HPV test every five years. These recommendations were published in the Annals of Internal Medicine.
Cancer screening refers to the use of tests to detect cancer in individuals who do not have any symptoms of the disease. In general, the primary goal of screening is to reduce cancer deaths by detecting cancer at an earlier and more treatable stage. For some types of cancer—including cervical cancer—screening can also play a role in cancer prevention. Screening for cervical cancer can identify precancerous changes to the cervix. Treatment of these precancers can then prevent the development of invasive cancer.
The Pap test is a screening test that has had a tremendous impact on cervical cancer incidence and mortality. During a Pap test, a sample of cells is removed from the cervix and evaluated under a microscope. If the cells appear abnormal, additional testing is often recommended.
More recently, tests for high-risk types of human papillomavirus (HPV) have also been incorporated into cervical cancer screening programs. Persistent HPV infection causes most cases of cervical cancer.
Decisions about how frequently screening tests should be performed can be quite complex. Although frequent testing may seem like a good thing, testing too frequently can increase the risks of screening without improving cancer outcomes. The most recent recommendations from the USPSTF are based on an updated review of the available research on cervical cancer screening. The primary recommendations are as follows:
- For women between the ages of 21 and 65 who are screened with a Pap test, testing is recommended every three years.
- Another screening option is the combination of a Pap test and an HPV test. If combination testing is performed, it is recommended every five years for women between the ages of 30 and 65. Routine HPV testing is not recommended for women under the age of 30 because many young women have HPV infections that will clear on their own without causing problems.
- Cervical cancer screening is not recommended for women under the age of 21.
- For women over the age of 65, cervical cancer screening is not recommended for women who have adequate prior screening and are not otherwise at high risk for cervical cancer.
These recommendations are intended for healthy women who do not have a history of cervical abnormalities. Women who have questions about the screening approach that’s best for them are advised to talk with their physician.
Reference: MoyerVAon behalf of the US Preventive Services Task Force. Screening for cervical cancer: US Preventive Services Task Force Recommendation Statement. Annals of Internal Medicine. Early online publication March 14, 2012.