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U.S. Preventive Services Task Force Recommendation Statement on Screening for Cervical Cancer

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As reported in JAMA, the U.S. Preventive Services Task Force (USPSTF) has updated its 2012 recommendations on screening for cervical cancer.

Key Recommendations

The key USPSTF recommendations on screening are as follows:

  • The USPSTF recommends screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years. For women aged 30 to 65 years, the USPSTF recommends screening every 3 years with cervical cytology alone, every 5 years with high-risk human papillomavirus (HPV) testing alone, or every 5 years with high-risk HPV testing in combination with cytology (cotesting).
  • The USPSTF recommends against screening for cervical cancer in women older than 65 years who have had adequate prior screening and are not otherwise at high risk for cervical cancer.
  • The USPSTF recommends against screening for cervical cancer in women younger than 21 years.
  • The USPSTF recommends against screening for cervical cancer in women who have had a hysterectomy with removal of the cervix and do not have a history of a high-grade precancerous lesion (ie, cervical intraepithelial neoplasia [CIN] grade 2 or 3) or cervical cancer.

Review Findings

To inform the update, the USPSTF reviewed evidence on screening for cervical cancer, focusing on clinical trials and cohort studies evaluating screening with high-risk HPV testing alone or high-risk HPV testing and cytology together (cotesting) compared with cervical cytology alone. The findings of this review included the following:

  • Screening with cervical cytology alone, primary high-risk HPV testing alone, or cotesting can detect high-grade precancerous cervical lesions and cervical cancer.
  • Screening women aged 21 to 65 years substantially reduces cervical cancer incidence and mortality.
  • The harms of screening for cervical cancer in women aged 30 to 65 years are moderate.
  • It is concluded with high certainty that the benefits of screening every 3 years with cytology alone in women aged 21 to 29 years substantially outweigh the harms.
  • It is concluded with high certainty that the benefits of screening every 3 years with cytology alone, every 5 years with high-risk HPV testing alone, or every 5 years with both tests (cotesting) in women aged 30 to 65 years outweigh the harms.
  • Screening women older than 65 years who have had adequate prior screening and women younger than 21 years does not provide significant benefit.
  • Screening women who have had a hysterectomy with removal of the cervix for indications other than a high-grade precancerous lesion or cervical cancer provides no benefit.
  • It is concluded with moderate to high certainty that screening women older than 65 years who have had adequate prior screening and are not otherwise at high risk for cervical cancer, screening women younger than 21 years, and screening women who have had a hysterectomy with removal of the cervix for indications other than a high-grade precancerous lesion or cervical cancer does not result in a positive net benefit.

Susan J. Curry, PhD, of the University of Iowa, Iowa City, is the corresponding author for the JAMA article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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