Which organizations have issued guidelines for cervical cancer screening?

Updated: Feb 12, 2019
  • Author: Cecelia H Boardman, MD; Chief Editor: Warner K Huh, MD  more...
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Answer

Guidelines on cervical cancer screening have been issued by the following organizations:

  • American Cancer Society (ACS)
  • American Congress of Obstetrics and Gynecology (ACOG)
  • American College of Physicians (ACP)
  • American Society of Clinical Pathology (ASCP)
  • American Society of Colposcopy and Cervical Pathology (ASCCP)
  • U.S. Preventive Services Task Force (USPSTF)

In May 2012, the ACS, the ASCCP, and the ASCP issued joint guidelines for cervical cancer screening, [3] followed shortly thereafter by updated guidelines from the USPSTF, whose recommendations are consistent with those of the ACS, ASCCP, and ASCP. [4] In November 2012, ACOG issued new screening guidelines that were also consistent with the recommendations of these groups. [2] In April 2015, the ACP issued best practice advice on cervical cancer screening in average-risk women; the recommendations were supported by ACOG and endorsed by ASCP. Screening recommendations for specific patient groups are as follows [3, 4, 2] :

Table 1. Cervical Cancer Screening Recommendations

Table. 1 (Open Table in a new window)

Patient Status

Recommended Screening Method

Comments

< 21 years old

No screening

 Sexual history is not a consideration

21-29 years old

Cytology alone every 3 years

 

30-65 years old

Preferred: HPV and cytology co-testing every 5 years

Acceptable: Cytology alone every 3 years

 

>65 years old

Screening can be discontinued after either three consecutive negative cytology tests or two negative cytology and HPV tests within 10 years, provided the most recent test was within 5 years

Women with a history of cervical intraepithelial neoplasia (CIN) 2, CIN 3, or adenocarcinoma in situ should continue routine age-based screening for at least 20 years

After total hysterectomy

No screening necessary

Applies to women without a cervix and without a history of CIN 2, CIN 3, adenocarcinoma in situ, or cancer in the past 20 years

After HPV vaccination

Follow the same age-specific recommendations as unvaccinated women

 

Although current guidelines advise against performing HPV testing in women younger than 30 years of age, and do not recommend HPV testing alone for primary cervical cancer screening, a growing body of evidence calls these recommendations into question. In April 2015, a panel of experts that included representatives from seven relevant organizations issued interim guidance that supports primary HPV testing as a reasonable technique for cervical cancer screening. [105]

The USPSTF updated their draft recommendations in 2017 and 2018 to recommend high-risk HPV testing alone every 5 years as an alternative to cytology screening alone every 3 years in women 30 years of age and older; or cotesting every5 years. [56, 113]


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