Abstract
An update to the American Cancer Society (ACS) guideline regarding screening for the early detection of cervical precancerous lesions and cancer is presented. The guidelines are based on a systematic evidence review, contributions from six working groups, and a recent symposium co-sponsored by the ACS, American Society for Colposcopy and Cervical Pathology (ASCCP), and American Society for Clinical Pathology (ASCP), which was attended by 25 organizations. The new screening recommendations address age-appropriate screening strategies, including the use of cytology and high-risk human papillomavirus (HPV) testing, follow-up (e.g., management of screen positives and screening interval for screen negatives) of women after screening, age at which to exit screening, future considerations regarding HPV testing alone as a primary screening approach, and screening strategies for women vaccinated against HPV16/18 infections.
Highlights
Cervical cancer screening has successfully decreased cervical cancer incidence and mortality
Cytology (Pap test) screening has been very successful in lowering cancer incidence and mortality in countries where good quality screening is available, yet false-positive results are common, since most abnormal cytology is not associated with concurrent CIN3 or cancer, and still a concern.[19, 20]
A recent systematic review of the available published evidence concluded that human papillomavirus (HPV) testing is very promising for primary screening of women aged 30 years and older, when coupled with cytology testing of HPV positive results, which may reduce the increase in false positives that would result from HPV testing alone.[111]
Summary
Cervical cancer screening has successfully decreased cervical cancer incidence and mortality.
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