ACOG Offers New Cervical Cancer Screening Recommendations

By Kelly Young

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

The American College of Obstetricians and Gynecologists has released a set of guidelines on cervical cancer screening.

Among the recommendations for average-risk women based on the highest level of scientific evidence:

• Screening should start at age 21.

• For those aged 21 to 29 years, screening should be done with cervical cytology alone every 3 years.

• For those aged 30 to 65, the preferred screening method is cotesting with cytology and human papillomavirus testing every 5 years. However, cytology alone every 3 years is acceptable.

• For women over age 65, screening should not be performed among those with recent negative screening results and no history of cervical intraepithelial neoplasia (CIN) 2 or higher.

• For women with total hysterectomy who've never had CIN 2 or higher, screening should not be performed.

NEJM Journal Watch Women's Health editor-in-chief Dr. Andrew M. Kaunitz commented: "In general, this guidance from ACOG reaffirms previously issued guidance regarding cervical cancer screening. New in this document, however, are recommendations regarding primary screening with HPV testing."