Cervical Cancer Screening: Here Are The Best Practice Guidelines

New findings published in the journal Annals of Internal medicine reveal new clinical advice that aims to reduce the need for screening of cervical cancer in average risk women who are not exhibiting symptoms.

"ACP's advice for cervical cancer screening is designed to maximize the benefits and minimize the harms of testing," said Dr. David Fleming, president of ACP, in a news release. "Historically, physicians have low adherence to cervical cancer screening recommendations, beginning screening too early, performing screening too often, and continuing to screen women at low risk, either by age criteria or after hysterectomy with removal of cervix."

Findings suggest women who may need to undergo cervical cancer screening every three years will require cytology tests starting at the age of 21. Furthermore, physicians require a combination of cytology and HPV testing every five years in average risk women over the age of 30 who prefer less frequent screenings.

As it currently stands, physicians are advised to stop screening average women over the age of 65 with three consecutive negative cytology results or two consecutive negative cytology plus HPV test results within the past decade. However, at this time, the ACP does not advise that women under the age of 21 be screened for cervical cancer as well as perform HPV testing in average risk women younger than 30 years, or screen average risk women of any age for cervical cancer if they have undergone a hysterectomy with removal of the cervix.

With most health procedures, there can also be some unpleasant side effects, including "discomfort with speculum examinations and colposcopies, pain and bleeding with cervical biopsies and excisional treatments, prolonged surveillance, potential adverse obstetrical outcomes with some excisional treatments, and false positive testing," according to the ACP. 

"By following ACP's Best Practice Advice, physicians can practice high value care by reducing over-screening, overtreatment, and unnecessarily higher costs," said Dr. George F. Sawaya of the University of California, San Francisco Center for Healthcare Value.

Health officials also believe that it's necessary to do a better job of explaining to women when tests should be done. 

"As physicians, we need to do a better job trying to tell patients when screening should start," added Tanveer Mir, physician and Chair-elect of the Board of Regents of the American College of Physicians. "The primary care physicians and gynecologists, all of us are in the same boat where we have to do a better job of educating our patients."