Updated USPSTF Cervical Cancer Screening Recommendations
Cervical cancer remains an important public health issue. The US Preventive Services Task Force (USPSTF) has issued an update to its 2003 cervical cancer screening recommendations based on current evidence (Moyer VA, on behalf of the USPSTF. Ann Intern Med. 2012;156:880-891). The key updated points in the new guidelines include:
- Cytology screening should be done every 3 years in women aged 21 to 65 years
- Women aged <21 years should not be screened, for lack of evidence for a net benefit
- There is no substantial difference in test performance between liquidbased and conventional cytology for the detection of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) and CIN3+ lesions
- Women aged <30 years should not be screened with human papillomavirus (HPV) testing
- HPV testing plus cytology every 5 years is an acceptable strategy for women aged 30 to 65 years.
In addition, the guidelines recommend against cervical cancer screening in older women (≥65 years) who have had adequate previous screening and are not otherwise at high risk for cervical cancer.
These guidelines apply to women who have a cervix, regardless of sexual history, but not to women with highgrade precancerous cervical lesions or cervical cancer, women who were exposed in utero to diethylstilbestrol, or immunocompromised women.
The new guidelines are based on a systematic review of the relevant evidence, including the benefits and harms of cervical cancer screening, as well as a computerized decision analysis. The USPSTF points out that for policy and coverage decisions, considerations beyond clinical benefits and harms are applicable.