USPSTF releases draft recommendations on cervical cancer screening

The U.S. Preventive Services Task Force has issued a draft recommendation on cervical cancer that states women aged 21 to 29 years should be screened with cytology (also known as a Pap test) every 3 years. The task force also stated that women aged 30 to 65 years should receive either screening with the Pap test every 3 years or the high-risk HPV test every 5 years.

“It is well established that the benefits of preventing cervical cancer far outweigh the harms, such as false-positive results, that would come from screening some women,” Carol Mangione, MD, MSPH, task force member, professor and primary care doctor from the David Geffen School of Medicine at the University of California, Los Angeles, told Healio Family Medicine in an interview.

The USPSTF also continues to recommend against cervical cancer screening in women who have had a hysterectomy, are younger than 21 years, are not otherwise at high risk for cervical cancer, and are older than 65 years who have had adequate prior screening.

Mangione said it is important for medical professionals to make a distinction between those who have had sufficient screening and those who have not.

“Some women get to 65 and may have health insurance for the first time when they enroll in Medicare. These patients who were previously uninsured, as well as African American and Native American women are at higher risk for not having been adequately screened,” she said. “It’s important that when people look at these recommendations they keep these groups in mind, and that medical professionals remember to make sure all women have had adequate access to screening tests for cervical cancer.”

The new draft recommendations are an update to the 2012 final recommendation, which recommended women aged 30 to 65 years receive both Pap tests and HPV tests at the same time. All the other components of the 2017 draft recommendations are consistent with the 2012 final recommendations.

“There are new studies about screening for cervical cancer, and the task force revisits a topic when there is new information,” Mangione said, adding that there are still research gaps regarding cervical cancer screening that need to be addressed.

“We need to find out more about what the best interval between screening tests is, as well as decisions on when to start and stop screening,” she said. “We also need information on the most effective ways to implement screening programs and how to reduce the barriers to accessing these programs.”

The USPSTF’s draft statement and evidence review has been posted for public comment on the USPSTF website: www.uspreventiveservicestaskforce.org. Input will be accepted through Oct. 9, 2017 at www.uspreventiveservicestaskforce.org/tfcomment.htm. – by Janel Miller

Disclosure: Mangione reports no relevant financial disclosures. Please see the report for a list of the other task force members relevant financial disclosures.