The American Cancer Society has released updated guidelines for cervical cancer screening that introduce self-collection of vaginal samples for HPV testing as an option and provide new guidance on when individuals can safely exit screening. The update is published in CA: A Cancer Journal for Clinicians.
“These updated recommendations will help to improve compliance with screening and reduce the risk of cervical cancer,” said Dr. Robert Smith, senior vice president of early cancer detection science at the American Cancer Society. “They are made possible as we continue to evolve our approach to screening for cervical cancer, primarily through research advancements, and the development of self-collection tools to broaden access to screening.”
The American Cancer Society recommends that average-risk women and individuals with a cervix at average risk initiate cervical cancer screening at age 25 and undergo primary HPV testing every five years through age 65. Research has shown that long-lasting infection with certain types of HPV causes nearly all cervical cancers.
For primary HPV testing, clinician-collected cervical specimens are preferred, but self-collected vaginal specimens are acceptable for cervical cancer screening. When self-collected vaginal specimens are HPV negative in the screening setting, repeat testing in three years is recommended.
For discontinuing screening, the American Cancer Society recommends that average-risk women or individuals with a cervix at average risk have negative primary HPV tests or negative co-testing using HPV tests and cytology testing at ages 60 and 65.
The Food and Drug Administration approved HPV self-collection testing as a safe and effective screening option. Cervical cancer screening programs have decreased cancer incidence by more than half since the mid-1970s. However, 13,360 cases are expected to be diagnosed in the United States this year, and an estimated 4,320 people will die from the disease.
“Geographic disparities continue to exist in cervical cancer incidence and mortality, with individuals living in rural areas more likely to be diagnosed with later-stage cervical cancer,” said Lisa Lacasse, president of ACS CAN. “Over 46 million, or 14%, of the U.S. population live in rural areas that often require the need to travel long distances to access health care. Self-collection options are a critical resource for these individuals and other underserved populations.”
The American Cancer Society does not recommend screening for women under age 25, women older than age 65 who have had adequate prior screening and are not otherwise at high risk, or women who have had a hysterectomy with removal of the cervix unless they have a history of high-grade precancerous lesions.
