New Updates for Cervical Cancer Screening

American Society of Clinical Oncology (ASCO) guidelines are updated periodically. An ASCO task force reviewed 7 existing guidelines on cervical cancer screening and conducted 4 systematic literature reviews. They also performed a cost effectiveness analysis of various screening recommendations, and issued updated cervical cancer screening guidelines in October 2016.

Human papillomavirus (HPV) DNA testing is recommended in all settings in which this testing is available. Visual inspection with acetic acid may be used in settings without HPV testing capability, and this screening is recommended for women aged 30-49 1 to 3 times per lifetime. Treatment options are cryotherapy or loop electrosurgical excision procedure in these “basic” settings.

In settings in which HPV testing is available, recommended age ranges and frequencies by setting are as follows: maximal (eg, extensive testing and treatment availability): ages 25 to 65, every 5 years; enhanced: ages 30 to 65, if 2 consecutive negative tests at 5-year intervals, then every 10 years; and limited (eg, minimal testing and treatment availability, which includes HPV testing): ages 30 to 49, every 10 years. Colposcopy is recommended for abnormal triage results. Loop electrosurgical excision procedure (or ablation) is recommended treatment. Twelve-month posttreatment follow-up is recommended in all settings.

Women who are HIV positive should be screened with HPV testing after diagnosis and screened twice as many times per lifetime as the general population. Screening is recommended at 6 weeks postpartum in basic settings; in other settings, screening is recommended at 6 months.

This guideline has been endorsed by the International Gynecologic Cancer Society and the American Society for Colposcopy and Cervical Pathology and is available here.