Cervical cancer screening and HPV guidelines

The American Cancer Society estimates that 12,360 women will be diagnosed with cervical cancer in 2014.  While rates of cervical cancer have declined over the years due to better screening measures, some women are not sure when they should begin the screening process.  Cervical cancer is caused by a virus known as Human Papilloma Virus or HPV.  The virus causes changes in the cells of the cervix and may lead to cancer.  Fortunately, a PAP smear is a basic test for women that can detect these changes early and lead to more effective treatment.  So when and how often do women need a PAP smear?

In 2013, ACOG (American College of Obstetricians and Gynecologists) released updated guidelines for cervical cancer screening as follows:

• Cervical cancer screening should start at age 21.  This is different than previous guidelines that recommended starting at age 18.
• Women aged 21-29 should have PAP smears ever 3 years.  This is different than yearly PAP smears which was recommended for a long time.  Women may still need annual screening if they have any cervical changes present.
• Women aged 30-65 should have a PAP smear and HPV testing every 5 years or a PAP every 3 years.
• Women should stop having PAP smears after the age of 65 if they have not had any moderate to severe cervical changes

Some exceptions to these guidelines do apply but in general, these are widely accepted to be the standard of care.  These recommendations are also consistent with those made by the US Preventive Services Task Force (USPSTF).

Cervical cancer is one type of cancer that can have a good outcome if proper screening practices are followed.  We know that it is caused by a type of virus and we have ways to detect the virus and treat the disease if it has led to biologic changes.  While many cases are detected in women without easy access to gynecological care, there are too many cases where patients have not followed up with their testing or are too hesitant to have a PAP smear.  Physicians, male and female alike, recognize the fact that women find a PAP smear uncomfortable and this is completely understandable.  However, if we do not take advantage of these great screening tools, we will lose to a disease that is preventable.  So please see your doctor and get tested!