There’s A Better Option For Cervical Cancer Screening: American Cancer Society

The new ACS guidelines argue that the HPV test should be the "preferred method of testing" as the United States is in a "transition period" away from the "former mainstay" of Pap smears.

So far no one is certain about how often you should be getting screened for cervical cancer?

One group of clinicians now says that you only need an HPV screening once every five years rather than a Pap smear every three years.

But some gynecologists warn that the emphasis on less frequent testing could have unintended consequences.

The American Cancer Society released new guidelines on cervical cancer screenings Thursday, recommending that people with a cervix start HPV testing at age 25, rather than age 21, and undergo HPV testing every five years through age 65.

An HPV test screens for human papillomavirus, high-risk strains of which cause cervical cancer. Another common test, the Pap test, is used to find cancer cells and cells that might become cancer. Performing both a Pap and HPV tests at the same time is called “co-testing.”

Both tests require a brief and often uncomfortable procedure where the doctor uses a speculum – a hinged device used to look into a vagina – and takes cell samples.

The new ACS guidelines argue that the HPV test should be the “preferred method of testing” as the United States is in a “transition period” away from the “former mainstay” of Pap smears.

The HPV test is more accurate than the Pap test – according to several new studies – and can be done less often, the ACS says. The FDA has also approved two primary HPV tests in recent years.

If primary HPV testing is not available, however, the ACS recommends individuals aged 25-65 years should be screened with co-testing every five years or the Pap test alone every three years.

The ACS said it included these options because access to an HPV test that has been approved by the FDA for primary screening may currently be limited in some settings, but that the options will not be included in future guidelines.

The ACS did not significantly adjust its recommendations for people older than 65 years. For that age group, the guidelines recommend discontinuing screening if they have no history of abnormal cells on the cervix within the past 25 years and have documented adequate negative prior screening in the 10-year period prior to age 65.

Previous guidelines laid out by the American Cancer Society in 2012 did not recommend HPV primary testing. Other groups that issue guidance on cervical cancer screening – including the American College of Gynecology and the Women’s Preventive Services Initiative – still do not recommend HPV primary testing.

For people aged 21 – 29 years, the groups recommended a Pap test alone every three years. People aged 30 – 65 years should have a Pap test and an HPV test every five years, but it’s also acceptable to have a Pap test alone every three years.

The U.S. Preventive Services Task Force, however, issued guidance in 2018 saying that HPV primary testing was acceptable for peopled aged 30-65.

The ACS said it pushed back the age when people need to begin testing to 25 because screening has not been shown to lower the rate of cancer in people 21-24, most HPV infections in people in this age group become undetectable in a couple years, and a vaccine for HPV has been in use for nearly 15 years, with more people of screening age protected from the majority of cervical cancers.

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