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Home Screening and Treatment Testing and Treatment ACOG Updates Cervical Cancer Screening Guidelines

ACOG Updates Cervical Cancer Screening Guidelines

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Updated guidelines issues by the American College of Obstetricians and Gynecologists (ACOG) say most women should be screened for cervical cancer once every three to five years.

ACOG’s guidelines essentially mirror those published earlier in 2012 by the American Cancer Society (ACS), the U.S. Preventive Services Task Force (USPSTF), and other organizations. Highlights include: • Cervical cancer screening with Pap tests should begin at age 21, regardless of sexual history

• Pap testing should not be done for most women more often than every three years, a big change from the traditional "annual Pap" regimen many women and doctors traditionally used. Women are still recommended to go for yearly “well woman” visits and, of course, those with abnormal Paps will be tested more often

• Rather than using a Pap test alone, HPV/Pap co-testing is now the preferred method of screening women age 30 and over. Such co-testing should only occur once every five years with women who have normal test results

• HPV testing should not be done in women under age 30 other than as follow-up to unclear Pap test results

• Cervical cancer screening can end for most women at age 65, provided she has no history of cervical pre-cancer or cancer, and has had at least three consecutive, normal Pap tests (or two normal HPV tests) within the last 10 years. Women at greater risk for cervical cancer (e.g., those with a history of cervical pre-cancer or cancer and those who are HIV-positive or otherwise have weakened immune systems) may require screening more frequently

The reason for moving away from the annual Pap is evidence shows little gain in testing more often, but potential harm of “over screening” such as follow-up exams (like colposcopy/biopsy) and treatment to the cervix, especially with women of child-bearing age.

The new guidelines are found in ACOG Practice Bulletin Number 131, Screening for Cervical Cancer, which will be published in the November issue of Obstetrics & Gynecology. Read the announcement on ACOG’s website.