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Cervical Cancer Screening Guidelines

Of all the gynecologic cancers, only cervical cancer has proven prevention and screening tools

Human papillomavirus (HPV) is the most common sexually transmitted infection in the U.S. according to the Centers for Disease Control and Prevention (CDC). It’s so common that nearly all sexually active men and women will have it at some point in their lives. In most cases, HPV goes away on its own and does not cause any health problems.

Almost all cervical cancer is caused by HPV. The virus has also been linked to cancers of the vulva, vagina, penis, anus, and throat. The HPV vaccine is available for males and females to prevent all HPV associated cancers. It is recommended for girls/boys ages 11-12, but can be given beginning at age 9. The WHO recommends at least one dose for those up to 15 years of age, although your physician may recommend two doses. For males and females through age 45 years, three doses are required. The HPV vaccine protects against half of the types of HPV that cause cervical cancer.

Screening Guidelines

One of the most common and trustworthy tests used to detect precancerous and cancerous gynecologic conditions is the HPV test. All cervical cancer screening is HPV based. The old Pap test is no longer standard of care. When a woman is positive for HPV, cervical cytology can inform her risk of pre-cancer (CIN3) and cancer disease. At this time the only treatment for pre-cancer disease is an office-based surgical procedure, but the Rogel Cancer Center has a therapeutic drug in study so that women in the future will not have to have the surgical procedure.

All women should consider cervical cancer screening at age 21.

  1. For those women screening between the ages of 21 and 25, cytology is the only test available to them. If the cytology is normal, she repeats the screen in 3 years. If the cytology is abnormal, she is tested for HPV to determine her risk of CIN 3.
  2. Women between the ages of 25/30 and 65 should have a HPV test. If the test is negative, she can repeat her screening every 5 years. If the HPV test is positive she must have cytology to inform her risk of CIN 3. HPV testing is the preferred approach.
  3. Women over age 65 who have had regular screenings with normal results should not be screened for cervical cancer. Women who have been diagnosed with CIN 3 or cervical cancer should continue to be screened every 5 years, unless currently infected with HPV.
  4. Women who have had their uterus and cervix removed in a hysterectomy should not be screened.
  5. Women who have had the HPV vaccine should still follow the screening recommendations for their age group.
  6. Women who are at high risk for cervical cancer may need to be screened more often. Women at high risk might include those with HIV infection, organ transplant, or exposure to the drug DES or on immunosuppressive drugs. They should talk with their doctor or nurse.

Still have questions?

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