In the middle of September, the US Preventive Services Task Force (USPSTF) released for public comment a new evidence review and draft of recommendations for cervical cancer screening.1 The major proposed change from previous USPSTF recommendations is that for average-risk women aged 30–65 years, screening with high-risk HPV testing alone is recommended as an alternative to cervical cytology alone, and cotesting is no longer recommended.
Responding to the USPSTF recommendations, Haywood L. Brown, MD, president of the American College of Obstetricians and Gynecologists (ACOG), and Anna-Barbara Moscicki, MD, president of the American Society for Colposcopy and Cervical Pathology (ASCCP), released the following statement.
“The incidence of cervical cancer in the United States has decreased significantly in the past 30 years because of widespread screening. The number of women dying from the disease also has dramatically decreased because of prevention and early detection of cervical cancer. However, suboptimal screening practices and lack of access to screening remain significant contributors to cervical cancer morbidity and mortality, emphasizing the importance of routine cervical cancer screening for women’s health.
“The major proposed change in the USPSTF’s draft recommendations is that clinicians screen for cervical cancer in average-risk women aged 30–65 years with either cervical cytology alone every 3 years or with high-risk human papillomavirus (HPV) testing alone every 5 years. Prior USPSTF guidance recommended cotesting with cytology and high-risk HPV testing instead of high-risk HPV testing alone.
“ACOG is reviewing the evidence the USPSTF used as the basis for its new draft guidance. At this time, ACOG continues to affirm the clinical guidance included in Practice Bulletin No. 168, ‘Cervical Cancer Screening and Prevention,’ which recommends that for women aged 30–65 years, cotesting with cytology and high-risk HPV testing every 5 years is preferred, and screening with cytology alone every 3 years is acceptable.2 The USPSTF recommendations for women younger than 21 years (no screening), for women aged 21–29 years (cytology alone every 3 years), and for women older than 65 years who have been adequately screened previously (no screening) have not changed and remain the same as ACOG’s guidance.
“In addition to routine cervical cancer screening, it is crucial that obstetrician–gynecologists and other women’s healthcare providers educate parents and patients on the benefits and safety of HPV vaccination for cervical cancer prevention, and offer HPV vaccines in their offices.
“As a partner to the USPSTF, ACOG issued a practice advisory to its fellows.3 Moreover, ACOG will submit formal comments to the Task Force during the public comment period. ACOG and ASCCP urge their members to submit comments to the USPSTF during the public comment period.”
- Cervical Cancer: Screening [online]. Draft Recommendation Statement. Rockville, Md: US Preventive Services Task Force, 2017. Available at: www.uspreventiveservicestaskforce.org/page/document/draft-recommendation-statement/cervical-cancer-screening2. Accessed October 6, 2017.
- Cervical Cancer Screening and Prevention. Practice Bulletin no. 168. Washington, DC: American Congress of Obstetricians and Gynecologists, 2016. Available at: www.acog.org/resources-and-publications/practice-bulletins/committee-on-practice-bulletins-gynecology/cervical-cancer-screening-and-prevention. Accessed October 6, 2017.
- Practice Advisory: Cervical Cancer Screening [online]. Washington, DC: American Congress of Obstetricians and Gynecologists, 2017. Available at: www.acog.org/about-acog/news-room/practice-advisories/practice-advisory-cervical-cancer-screening. Accessed October 6, 2017.