USPSTF proposes updates to cervical cancer screening guidelines

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The US Preventive Services Task Force (USPSTF) has issued a draft recommendation for cervical cancer screening aimed at enhancing early detection while minimizing unnecessary interventions. This update highlights that human papillomavirus (HPV) screening gives women ages 30 to 65 years the best balance of benefits and harms, and introduces self-collection of HPV samples as an effective alternative.

Key recommendations:

1. Women aged 21 to 29 years: Continue screening every 3 years using the Pap test.
2. Women aged 30 to 65 years: Opt for screening every 5 years with an HPV test. Other effective alternatives include:
   1. A Pap test every 3 years.
   2. Co-testing (Pap and HPV) every 5 years.
3. Discontinuation of screening:
   1. Women under 21.
   2. Women over age 65 with a history of normal screening results.
   3. Women who have had a total hysterectomy for non-cancer reasons.

A new option: Self-collected HPV testing

For the first time, the USPSTF endorses self-collected HPV samples, an innovation expected to increase accessibility, particularly for underserved populations. According to Task Force member Esa Davis, MD, MPH, "Women who would be more comfortable collecting their HPV test sample themselves can now do so. We hope that this new, effective option helps even more women get screened regularly."

Supporting evidence

The recommendation underscores the importance of regular screenings in reducing cervical cancer rates. Nearly all cases of cervical cancer are caused by HPV, a sexually transmitted infection. “The latest science shows that screening for cervical cancer with an HPV test is the optimal approach for women who are 30 to 65 years old,” stated John Wong, MD, MACP, vice chair of the Task Force. He also noted, "Pap tests continue to be the best option for women in their 20s."

Additionally, Wanda Nicholson, MD, MPH, MBA, chair of the Task Force, emphasized, “Most cases of cervical cancer are in women who have not been regularly screened or appropriately treated after an abnormal test result. That’s why it’s so important that women get screened regularly, so cancer can be prevented or caught early when it’s treatable.”

Special considerations

The guidelines apply broadly to all individuals assigned female at birth but exclude those at higher risk due to conditions like HIV or a history of cervical cancer.

Public involvement

The draft recommendation is open for public comment through January 13, 2025. For details and submissions, visit USPSTF's comment page.

Reference:

US Preventive Services Task Force. US Preventive Services Task Force Issues Draft Recommendation Statement on Screening for Cervical Cancer. USPSTF Bulletin. December 10, 2024. Accessed December 10, 2024. https://www.uspreventiveservicestaskforce.org/uspstf/sites/default/files/file/supporting_documents/cervical-cancer-screening-draft-rec-bulletin_0.pdf