Updated November 16, 2012
The College of American Pathologists recommends regular cervical cancer screening beginning at age 21. Current data indicate that most women under the age of 30 will benefit from cervical cancer screening every three years. After age 30, co-testing with HR HPV and Pap testing is acceptable with intervals of five years. Cessation of routine cervical cancer screening can be considered at the age of 65 without a history of significant cervical epithelial cell abnormality.
The appropriate screening interval should be determined by each patient in consultation with her primary care physician, taking into account detailed patient history and risk factors. Women who are younger than 30 should not have the combined human papillomavirus (HPV) and Pap tests at their routine visit, as many women in this age group acquire human papillomavirus (HPV) positive, but may never develop cervical cancer. Women under the age of 21 should not be tested for HPV. Low-risk HPV testing should not be used in cervical cancer screening.
Inappropriate HPV testing may identify many who are HPV positive, but whose infections are only temporary, causing unnecessary treatment and harm.
- The Pap test is the most effective tool we have to prevent cervical cancer and all sexually active women over the age of 21 should have a regular Pap test. In addition, for women 30 years of age and older, it is appropriate that they also have an HPV test, as using both tests for women in this age group even further increases the chances for identifying precancerous changes. The Pap test is still the most effective tool, but no test is perfect, and adding the HPV test for women 30 and older, further enhances their chances for early diagnosis.
- Since the introduction of Pap screening programs in the US, the number of cervical cancer cases has decreased by 70 percent.
- The Pap test is the most effective tool we have to prevent cervical cancer, because it detects and allows for treatment of early precancerous changes in the cervix before invasive cancer has a chance to develop.
- No test is perfect, however, so the best way to prevent cervical cancer is to have Pap tests at regularly scheduled intervals.
- The College of American Pathologists encourages regular cervical cancer screening for all women who are sexually active at the age of 21 years.
- Current data indicate that most women under the age of 30 will benefit from regular cervical cancer screening.
- Lengthened intervals of cervical cancer screening may be appropriate for some women depending upon specific clinical circumstances, including age, high-risk human papillomavirus (HR-HPV) status, and other risk factors for cervical cancer.
- Pathologists agree that human papillomavirus (HPV) infection is necessary for the development of precancerous cervical disease that may eventually progress to cervical cancer if left untreated.
- Human papillomavirus (HPV) is the most common sexually acquired infection in the US, occurs in both men and women, and is most common in adolescents and young adults.
- Most sexually active people will acquire an HPV infection. Transmission is by intimate skin-to-skin contact.
- An HPV infection most often is temporary. The virus is usually cleared by the immune system without treatment in less than two years in healthy people.
- HPV infection causes no symptoms, and most people do not know that they have it. There is currently no treatment for HPV infection.
- It is not possible to determine the source of a human papillomavirus (HPV) infection.
- Condoms lower the rate of HPV infection, but offer incomplete protection.
- There are more than 40 types of human papillomaviruses (HPV) that infect the anogenital (vulva, cervix, anus, and penis) area. Based on the risk of causing cervical cancer, they are grouped into low-risk and high-risk categories.
- Low-risk HPV types cause genital warts and cellular changes which are detected by a Pap test. These changes are usually temporary and do not progress to cervical cancer.
- Cervical cancer usually does not develop unless high risk HPV infection persists over many years. There are other contributing factors to the development of cancers such as smoking, immunosupression, etc.
- It is important to remember, however, that human papillomavirus (HPV) infections are very common but cervical cancer is relatively rare.
- It is appropriate that women 30 years of age or older have both the high risk human papillomavirus (HR-HPV) DNA test and a Pap test at the time of routine screening, as using both tests for women in this age group even further increases the chances for identifying precancerous changes. It is important to note that the Pap test is still the most effective tool, but no test is perfect, and adding the HPV test further enhances the chances for early diagnosis in women 30 years of age and older.
- For women 30 years of age and older, if both the high-risk human papillomavirus (HR-HPV) DNA test and the Pap test are negative, it is highly unlikely that a woman has precancerous changes or cancer. Because cervical cancer develops so slowly, when both tests are negative, the screening interval can be extended.
- Women who are younger than 30 should not have the combined human papillomavirus (HPV) and Pap test at their routine screening visit. Unlike older women, younger women often have HPV infections. HPV infection is usually temporary and in most cases the virus is cleared by the immune system without any treatment in less than two years.
- Vaccination against specific types of human papillomaviruses (HPV) is another way to reduce infection rates and thereby reduce the incidence of cervical cancer. FDA approved vaccines are available in the United States and provides protection against low–risk and high-risk types which protects against 90 percent of genital warts and 70 percent of cervical cancers. To be most effective, vaccines should be administered before a person is sexually active. The vaccine is available for boys and girls.
- Even vaccinated women will still need to have cervical cancer screening because vaccination does not eliminate all risk of cancer.