In March 2012 new recommendations for cervical cancer screening have been released by two separate groups: the U.S. Preventive Services Task Force (USPSTF) and a multidisciplinary partnership among the American Cancer Society/American Society for Colposcopy and Cervical Pathology/American Society for Clinical Pathology (ACS/ASCCP/ASCP).

Table: USPSTF and ACS/ASCCP/ASCP Guidelines at a Glance*

Population

USPSTF ‡

ACS/ASCCP/ASCP§

Younger than 21 years

Recommends against screening.

Grade: D recommendation.

Women should not be screened regardless of the age of sexual initiation or other risk factors.?

21–29 years

 

Recommends screening with cytology every 3 years.

 Grade: A recommendation.

Screening with cytology alone every 3 years is recommended.

30–65 years

Recommends screening with cytology every 3 years or for women who want to lengthen the screening interval, screening with a combination of cytology and HPV testing every 5 years.

 Grade: A recommendation.

Screening with cytology and HPV testing (“co-testing”) every 5 years (preferred) or cytology alone every 3 years (acceptable) is recommended.

Older than 65 years

Recommends against screening women who have had adequate prior screening  and are not otherwise at high risk for cervical cancer. Grade: D recommendation.

 

Women with evidence of adequate negative prior screening  and no history of CIN2+ within the last 20 years should not be screened. Screening should not be resumed for any reason, even if a woman reports having a new sexual partner.

After hysterectomy

Recommends against screening in women who have had a hysterectomy with removal of the cervix and who do not have a history of a high-grade precancerous lesion (ie, CIN 2 or 3) or cervical cancer.

Grade: D recommendation

Women of any age following a hysterectomy with removal of the cervix who have no history of CIN2+ should not be screened for vaginal cancer. Evidence of adequate negative prior screening is not required. Screening should not be resumed for any reason, including if a woman reports having a new sexual partner.

HPV vaccinated

Women who have been vaccinated should continue to be screened.

Recommended screening practices should not change on the basis of HPV vaccination status.

 

 * USPSTF, U.S. Preventive Services Task Force; ACS/ASCCP/ASCP, American Cancer Society/American Society for Colposcopy and Cervical Pathology; ASCP, American Society for Clinical Pathology; HPV, human papillomavirus; CIN, cervical intraepithelial neoplasia.