American Cancer Society: Start cervical cancer screening at
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An updated guideline issued by the American Cancer Society recommends cervical cancer screening with the HPV test every 5 years from age 25 years to 65 years. The society’s previous guideline, issued in 2012, recommended initiation of cervical cancer screening at age 21 years. Since then, HPV vaccination has led to decreased rates of precancerous cervical changes among women aged 20 to 24 years, data have shown. In addition, screening has not been shown to lower the rate of cervical cancer among women in this younger age group, whose HPV infections mostly become undetectable in 1 to 2 years, according to a press release.

The society estimated that the change to primary HPV testing starting at age 25 years would prevent 13% more cervical cancers and 7% more cervical cancer deaths than the previously recommended strategy.

The updated guideline also recommends that health care providers transition to primary HPV testing only, based upon data that suggest higher accuracy with the HPV test, which can be administered less often than the Pap test. However, HPV/Pap cotesting every 5 years or Pap testing alone every 3 years are acceptable options, because some laboratories have not yet transitioned to primary HPV testing. The update is based on decades of studies comparing the effectiveness of HPV testing compared with cytology, and bolstered by evidence of the impact of HPV vaccination, including a dramatic decline in cervical precancers and, more recently, cervical cancers among young women. Screening and management for the detection of cervical cancer and its precursors are based on a more robust understanding of the risk from persistent HPV infection.