Cervical Cancer Screening Should Begin Later, Cancer Group Says

By Amy Orciari Herman

Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS

The American Cancer Society (ACS) now says average-risk individuals should begin cervical cancer screening at age 25 — rather than at age 21, as recommended in 2012. The group's guideline update appears in CA: A Cancer Journal for Clinicians.

The other major change from 2012: The preferred screening approach is primary human papillomavirus (HPV) testing (i.e., stand-alone testing for high-risk HPV types) every 5 years through age 65. If FDA-approved primary HPV testing is not available, then HPV-cytology cotesting every 5 years or cytology alone every 3 years is acceptable.

Of note, there are currently two approved primary HPV tests, and access to them may be limited. The ACS says that cotesting or cytology alone "should be phased out once full access to primary HPV testing for cervical cancer screening is available without barriers."

The guidance applies to all average-risk, asymptomatic people with a cervix, including transgender men who still have a cervix. Such individuals should be screened regardless of their HPV vaccination status or sexual history.