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JAMA Clinical Guidelines Synopsis |

Cervical Cancer Screening

Anna Volerman, MD1; Adam S. Cifu, MD1
[+] Author Affiliations
1Department of Medicine, University of Chicago, Chicago, Illinois
JAMA. 2014;312(21):2279-2280. doi:10.1001/jama.2014.14992.
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Guideline title Screening for Cervical Cancer

Developer American College of Obstetricians and Gynecologists (ACOG)

Release date October 22, 2012

Prior version November 20, 2009

Funding source ACOG

Target population Women aged 21-65 years

Major recommendations

  • Screening for cervical cancer should begin at 21 years of age, regardless of sexual behaviors and risk factors.

  • For women 21-29 years old, cervical cytology alone should be performed every 3 years.

  • For women 30-65 years old, co-testing with cervical cytology and human papillomavirus (HPV) testing should be performed every 5 years; an alternative screening method is cytology alone every 3 years.

  • Screening should occur more frequently in women who have established risk factors for cervical cancer (including HIV infection, immunocompromised status, exposure to diethylstilbestrol in utero, and history of cervical intraepithelial neoplasia [CIN] 2, CIN 3, or cancer).

  • Screening should stop at 65 years, as long as there are adequate negative results (3 consecutive negative cytology or 2 consecutive negative co-test results in prior 10 years with most recent in past 5 years) and no history of CIN 2 or higher.

  • Cervical cytology may be collected via liquid-based or conventional Pap smears.

  • Screening should not be performed with HPV testing alone.

  • If co-testing results show atypical squamous cells of undetermined significance (ASCUS) cytology and negative HPV, women should continue routine screening according to their age.

  • If co-testing results show negative cytology and positive HPV, women may repeat co-testing in 12 months or perform HPV genotype-specific testing.

  • Screening recommendations remain the same irrespective of whether women received the HPV vaccine.

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