Cervical Cancer Screening in Average-Risk Women: Best Practice Advice From the Clinical Guidelines Committee of the American College of Physicians

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Abstract

Description:

The purpose of this best practice advice article is to describe the indications for screening for cervical cancer in asymptomatic, average-risk women aged 21 years or older.

Methods:

The evidence reviewed in this work is a distillation of relevant publications (including systematic reviews) used to support current guidelines.

Best Practice Advice 1:

Clinicians should not screen average-risk women younger than 21 years for cervical cancer.

Best Practice Advice 2:

Clinicians should start screening average-risk women for cervical cancer at age 21 years once every 3 years with cytology (cytologic tests without human papillomavirus [HPV] tests).

Best Practice Advice 3:

Clinicians should not screen average-risk women for cervical cancer with cytology more often than once every 3 years.

Best Practice Advice 4:

Clinicians may use a combination of cytology and HPV testing once every 5 years in average-risk women aged 30 years or older who prefer screening less often than every 3 years.

Best Practice Advice 5:

Clinicians should not perform HPV testing in average-risk women younger than 30 years.

Best Practice Advice 6:

Clinicians should stop screening average-risk women older than 65 years for cervical cancer if they have had 3 consecutive negative cytology results or 2 consecutive negative cytology plus HPV test results within 10 years, with the most recent test performed within 5 years.

Best Practice Advice 7:

Clinicians should not screen average-risk women of any age for cervical cancer if they have had a hysterectomy with removal of the cervix.

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