Recent updates to cervical cancer screening guidelines from the American Cancer Society (ACS) are offering novel options for individuals with a cervix, with a significant focus on primary HPV testing and the acceptance of self-collected samples. These recommendations aim to improve access to screening and reduce the incidence of this preventable cancer. The updated guidelines clarify when screening should begin and complete, providing a more nuanced approach to preventative care.
Cervical cancer, while often unhurried-growing and highly treatable when detected early, remains a significant health concern. According to the National Cancer Institute, nearly 14,000 cases of cervical cancer are diagnosed in the United States each year, resulting in over 4,000 deaths annually . The ACS guidelines, alongside those from the U.S. Preventive Services Task Force (USPSTF), play a crucial role in shaping preventative healthcare practices and influencing insurance coverage for these screenings.
What are the New ACS Recommendations?
The cornerstone of the updated ACS recommendations is the prioritization of primary HPV testing. This method directly tests for the presence of high-risk human papillomavirus (HPV) types known to cause the vast majority of cervical cancers. If primary HPV testing isn’t available, the ACS recommends co-testing – combining an HPV test with a Pap test (also known as cytology). As a fallback, a Pap test alone remains an acceptable option.
A key shift in the guidelines is the recommended starting age for screening: 25. This is based on the understanding that cervical cancer is relatively rare in younger individuals. This differs from current USPSTF recommendations, which suggest Pap tests between ages 21 and 29, transitioning to HPV primary testing or co-testing at age 30 .
Perhaps the most significant change is the acceptance of self-collected HPV tests. Traditionally, samples for both HPV and Pap tests were collected by healthcare providers during a pelvic exam. While provider-collected samples remain preferred, the ACS acknowledges that access to these exams can be limited or uncomfortable for some. Self-collection offers a viable alternative, potentially broadening access to crucial screening.
Understanding Screening Frequency and When to Stop
The frequency of screening depends on the type of test used and how the sample was collected. Individuals receiving HPV primary testing or co-testing with provider-collected samples and normal results should be screened again in five years. Those who self-collect samples for HPV testing and have normal results should return for screening in three years. A Pap test alone, with normal results, requires repeat screening every three years. Abnormal results will necessitate more frequent monitoring.
The ACS recommends that individuals can discontinue screening at age 65 if they have had ten years of consistently normal results. This means either negative HPV tests at ages 60 and 65, or three consecutive negative Pap tests, with the most recent occurring at age 65.
The Impact of Screening and Increased Accessibility
Widespread cervical cancer screening in the U.S. Has demonstrably reduced the incidence of the disease by more than half since the mid-1970s. However, over half of cervical cancer diagnoses today occur in individuals who have never been screened or who are screened infrequently. The new guidelines, with their emphasis on self-collection, aim to address these disparities.
“These updated recommendations will help to improve compliance with screening and reduce the risk of cervical cancer,” explained Dr. Robert Smith, senior vice president, early cancer detection science at the American Cancer Society . He further emphasized that the development of self-collection tools will “broaden access to screening.” Testing can now potentially be conducted in primary care offices, urgent care clinics, mobile clinics, pharmacies, or even at home, offering greater convenience and accessibility.
Disclaimer: This information is intended for general knowledge and informational purposes only, and does not constitute medical advice. It is essential to consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
The evolving landscape of cervical cancer screening offers promising avenues for prevention and early detection. As the USPSTF continues to revise its own guidelines, staying informed about the latest recommendations is crucial for individuals seeking to protect their health. Share this information with your network and discuss these options with your healthcare provider to determine the best screening plan for your individual needs.
