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U.S. Cervical Cancer Screening Guidelines

The American College of Obstetricians and Gynecologists has developed new guidelines that slightly alter previous recommendations for cervical cancer screening. The guidelines state that cervical cancer screening should begin at age 21 years, a change for the previous recommendation of age 18 or at the start of sexual activity. Screening prior to age 21 could lead to unnecessary and potentially harmful evaluation and treatment, according to a statement issued by the group's president. In addition, the guidelines call for women 30 and older to be screened for cervical cancer once every 2 years, instead of every year. The guidelines also recommend women 30 and older who have had 3 consecutive negative tests be screened once every 3 years.

Cervical cancer screening is commonly performed with a Pap test—a screening test used to examine cells from the cervix and the vagina.  Cervical and vaginal cells are studied to determine whether there is evidence of cancer or pre-cancerous changes. If abnormal cells are found, they are classified according to their degree of abnormality. Most abnormal Pap smears are caused by cervical infections or inflammation which can usually be successfully treated before leading to cancer.

Previously, the American Cancer Society and other groups recommended that women begin receiving Pap tests at age 18 or at the time they become sexually active. However, research has shown that beginning the screening this early can lead to unnecessary follow-up testing and treatment. Therefore, medical experts have been studying the appropriate time to begin testing.

According to the new American College of Obstetricians and Gynecologists, cervical cancer screening should begin at age 21 years regardless of sexual history. Screening for these women is recommended every 2 years. According to the ACOG, screening before age 21 should be avoided because women less than 21 years old are at very low risk of cancer. Screening these women may lead to unnecessary and harmful evaluation and treatment. The group says that evidence also shows that screening women every year has little benefit over screening every other year. Moreover, healthy women 30 or older should be given a Pap test once every three years, according to the new guidelines. Finally, the ACOG calls for screening to stop at around age 65 to 70, as long as a woman has had 3 negative tests in the last 10 years. Women who have had a hysterectomy for non-cancerous reasons do not need to be screened.

The new cervical cancer screening guidelines have caused confusion among some women because they were publicized immediately after the U.S. Preventive Services Task Force issued its controversial new guidelines for breast cancer screening. Those guidelines sparked a firestorm of controversy among the medical community, advocacy groups, the media, and many women. However, the cervical cancer screening guidelines are completely independent from the breast cancer screening guidelines, and the medical community appears to support the changes to the cervical cancer community. The American Cancer Society and National Cervical Cancer Coalition both expressed support for them.

Medical professional emphasized that while the new cervical cancer screening guidelines slightly alter the ages and frequency of Pap tests, it is very important that women continue to be screened. Most women who die from cervical cancer have never been screened or have not been screened within the past 5 years. As with all revised medical screening guidelines, women should talk to their doctors about the most appropriate screening regimen for them, based on their individual medical circumstances.

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