New US Preventive Services Task Force Recommendations for Cervical Cancer Screening

Focus on screening with hrHPV testing alone or its cotesting with cytology compared with cervical cytology alone

On 21 August 2018, the US Preventive Services Task Force published new recommendations as an update of previous 2012 recommendations on screening for cervical cancer.

They reviewed the evidence on cervical cancer screening, with a focus on clinical trials and cohort studies that evaluated screening with high-risk human papillomavirus (hrHPV) testing alone or hrHPV cotesting with cytology compared with cervical cytology alone.

The Task Force also commissioned a decision analysis model to evaluate the age at which to begin and end screening, the optimal interval for screening, the effectiveness of different screening strategies, and related benefits and harms of different screening strategies.

They concluded that the benefits of screening every 3 years with cytology alone in women aged 21 to 29 years substantially outweigh the harms.

Furthermore, the Task Force concluded that the benefits of screening every 3 years with cytology alone, every 5 years with hrHPV testing alone, or every 5 years cotesting in women aged 30 to 65 years outweigh the harms.

Screening women older than 65 years who have had adequate prior screening and women younger than 21 years does not provide significant benefit.

Screening women who have had a hysterectomy with removal of the cervix for indications other than a high-grade precancerous lesion or cervical cancer provides no benefit.

In the article published in JAMA, the Task Force has also noted that the number of deaths from cervical cancer in the United States has decreased substantially since the implementation of widespread cervical cancer screening.

Reference

US Preventive Services Task Force. Screening for Cervical Cancer US Preventive Services Task Force Recommendation Statement. JAMA. 2018;320(7):674-686. doi:10.1001/jama.2018.10897