Somewhat lost in the recent debate over mammography recommendations were the updated cervical cancer screening guidelines from the American College of Obstetricians and Gynecologists. Although the Practice Bulletin itself is limited to subscription access, ACOG issued a press release that outlines two important changes:
- Cervical cancer screening should begin at age 21 years (regardless of sexual history). 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.
- Cervical cytology screening is recommended every 2 years for women between the ages of 21 years and 29 years. Evidence shows that screening women every year has little benefit over screening every other year.
Older guidelines from ACOG and other groups varied but tended to suggest that women start screening at age 18 or 21, or at the onset or within 3 years of the onset of sexual activity, whichever came first, and often recommended yearly screening.
The new guidelines also suggest that women women 30 and older should be screened for cervical cancer whether by conventional or liquid PAP test once every 2 years, instead of annually, and after 3 consecutive negative tests be screened once every 3 years. Women with certain risk factors such as a history of cervical dysplasia or cancer, HIV, other causes of immunosuppression, or exposure to the drug DES may need read frequent screening.
Unchanged in the guideline is that women who have undergone total hysterectomy no longer need a Pap test, and that women ages 65 and older can discontinue cervical cancer screening if they have three consecutive negative Pap tests and no abnormal tests in the previous 10 years.
The American Cancer Society issued a statement that the revised ACOG guidelines “aren’t very different than the guidelines currently outlined by ACS, which were last updated in 2002;” they’re also very similar to the issued in 2003 by the USPSTF. provides a freely available summary of the guideline.