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Task Force Announces New Cervical Cancer Screening Guidelines

  • Posted: January 22, 2003

The National Cancer Institute (NCI) supports new guidelines on cervical cancer screening released today by the U.S. Preventive Services Task Force (USPSTF). The new guidelines, similar to ones published by the American Cancer Society in November, are based on a review of recent research advances in cervical cancer screening and detection and in understanding the course of the disease, including the recently discovered role of the human papillomavirus (HPV).

"The premier experts in the field have worked on the guidelines developed by U.S. Preventive Services Task Force and the American Cancer Society," said Peter Greenwald, M.D., Dr.P.H., director of the Division of Cancer Prevention at NCI. "The key to continued reductions in deaths from cervical cancer is early detection, and these guidelines will help women and their doctors make informed choices about screening."

During 2002, about 4,100 women in the United States died from cervical cancer. This number reflects an estimated 70 percent decline from the mid-20th century, when the Papanicolaou (Pap) test - the collection of cells from the cervix for examination under a microscope - was first introduced as a screening tool. Cervical cancer screening is important to detect significant abnormal cell changes that may arise before cancer develops.

In recent years, researchers have identified HPV, which is transmitted through sex, as the main cause of cervical cancer. HPV infections are very common, however, while cervical cancer is not. Most HPV infections go away without treatment and do not lead to cervical cancer.

The USPSTF guidelines are available at http://www.ahrq.gov/clinic/3rduspstf/cervcan/cervcanrr.htm. The American Cancer Society guidelines can be found at http://caonline.amcancersoc.org/cgi/content/short/52/6/342. NCI's summary points for cervical cancer screening follow:

   •  Cervical cancer screening should begin approximately three years after a woman begins having sexual intercourse, but no later than at 21 years old.
   •  Experts recommend waiting approximately three years following the initiation of sexual activity because transient HPV infections and cervical cell changes that are not significant are common and it takes years for a significant abnormality or cancer to develop. Cervical cancer is extremely rare in women under the age of 25.
   •  Women should have a Pap test at least once every three years.
   •  Women 65 to 70 years of age who have had at least three normal Pap tests and no abnormal Pap tests in the last 10 years may decide, upon consultation with their healthcare provider, to stop cervical cancer screening.
   •  Women who have had a total hysterectomy (removal of the uterus and cervix) do not need to undergo cervical cancer screening, unless the surgery was done as a treatment for cervical precancer or cancer.
   •  Women should seek expert medical advice about when they should begin screening, how often they should be screened, and when they can discontinue cervical screenings, especially if they are at higher than average risk of cervical cancer due to factors such as HIV infection.

For more information about HPV, please go to http://newscenter.cancer.gov/BenchMarks/archives/2002_04/related_article.html.

For further information about cervical cancer and cervical cancer screening, please call the National Cancer Institute's Cancer Information Service toll-free at 1-800-4 CANCER.

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