Update on Cervical Cancer Screening Guidelines
According to the American Cancer Society’s estimates for cervical cancer in the United States for 2016:
- About 12,990 new cases of invasive cervical cancer will be diagnosed.
- About 4,120 women will die from cervical cancer.
Historically, cervical cancer was once one of the most common causes of cancer death for American women. But over the last 30 years, the cervical cancer death rate has gone down by more than 50 percent. The main reason for this change was the increased use of the Pap test. As you know, pap smears are no longer recommended annually for all women and, in certain populations, the addition of HPV testing has improved the sensitivity of detection of cervical dysplasia and cervical cancer.
The American Cancer Society regularly reviews the science and updates screening recommendations when new evidence suggests that a change may be needed.
The latest recommendations are:
- All women should begin cervical cancer screening at age 21.
- Women between the ages of 21 and 29 should have a Pap test every three years. They should not be tested for HPV unless it is needed after an abnormal Pap test result.
- Women between the ages of 30 and 65 should have both a Pap test and an HPV test every five years. This is the preferred approach, but it is also okay to have a Pap test alone every three years.
- Women over age 65 who have had regular screenings with normal results should not be screened for cervical cancer. Women who have been diagnosed with cervical pre-cancer should continue to be screened.
- Women who have had their uterus and cervix removed in a hysterectomy and have no history of cervical cancer or pre-cancer should not be screened.
- Women who have had the HPV vaccine should still follow the screening recommendations for their age group.
- Women who are at high risk for cervical cancer may need to be screened more often. Women at high risk might include those with HIV infection, organ transplant, or exposure to the drug DES. They should talk with their provider about risk factors.
We encourage our medical colleagues to stress the importance of HPV vaccination for female and male patients (from age 11 to 26). It has been clearly shown to lower the risk for cervix cancer and can possibly reduce oral cancer.
In short, the American Cancer Society no longer recommends that women get a Pap test every year, because it generally takes much longer than that – 10 to 20 years – for cervical cancer to develop, and overly frequent screening could lead to procedures that are not needed. However women still need examination of the vulva, vagina and cervix. If a woman is having bleeding after intercourse, bleeding after menopause, bleeding between her periods, has pelvic discomfort or pain, or pain with sexual activity then testing should be considered, especially if she is not up to date.
Treatment of cervical cancer may involve a radical hysterectomy or a combination of chemotherapy, targeted chemotherapy and radiation therapy.