Cervical Cancer Screening for Individuals at Average Risk
Recommendations
The ACS recommends that individuals with a cervix initiate cervical cancer screening at age 25 years and undergo primary HPV testing every 5 years through age 65 years (preferred). If primary HPV testing is not available, individuals aged 25 to 65 years should be screened with cotesting (HPV testing in combination with cytology) every 5 years or cytology alone every 3 years (acceptable) (strong recommendation)
Cotesting or cytology‐alone testing are acceptable options for cervical cancer screening because access to an FDA‐approved primary HPV test may be limited in some settings. As the United States makes the transition to primary HPV testing, the use of both cotesting and cytology for cervical cancer screening will not be included in future guidelines.
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When to Stop Cervical Cancer Screening
The ACS recommends that individuals with a cervix who are older than age 65 years, who have no history of CIN2+ within the past 25 years, and who have documented adequate negative prior screening in the prior 10 years discontinue cervical cancer screening with any modality (qualified recommendation).
- Adequate negative prior screening is currently defined as 2 consecutive negative HPV tests, or 2 consecutive negative cotests, or 3 consecutive negative cytology tests within the past 10 years, with the most recent test occurring within the recommended interval for the test used. These criteria do not apply to individuals who are currently under surveillance for abnormal screening results.
- Individuals aged >65 years without conditions limiting life expectancy for whom sufficient documentation of prior screening is not available should be screened until cessation criteria are met.
- Cervical cancer screening may be discontinued in individuals of any age with limited life expectancy.
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Recommendation Grading
Overview
Title
Cervical Cancer Screening for Individuals at Average Risk
Authoring Organization
American Cancer Society
Publication Month/Year
July 30, 2020
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Female, Male, Adult, Older adult
Health Care Settings
Ambulatory, Hospital
Intended Users
Social worker, physician
Scope
Assessment and screening
Diseases/Conditions (MeSH)
D002583 - Uterine Cervical Neoplasms, D008403 - Mass Screening
Keywords
guideline, Cervical cancer screening, cervical neoplasms, cervix neoplasms, mass screening, prevention and control