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

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.