The American Cancer Society (ACS) recently announced significant revisions to its cervical cancer screening guidelines. These updated recommendations incorporate scientific advancements, shifting the standard approach for individuals at average risk. The key changes include raising the initial screening age, prioritizing HPV testing, and introducing a new self-collection option. Experts hope these updates will help boost screening adherence and reduce the global incidence of this preventable cancer.
Cervical cancer remains the fourth most common cancer among women worldwide. Projected case numbers could jump by almost 57% by 2050, highlighting the urgent need for effective preventive measures. The updated guidelines aim to address this public health challenge by maximizing early detection.
One of the most notable changes involves the age when screening should begin. The ACS now recommends that individuals at average risk for cervical cancer start screenings at age 25, up from the previous start age. After this initial screening, the suggested interval for testing is every three to five years, depending on the method used.
The ACS has also formally updated its preferred method of screening. Human papillomavirus (HPV) testing, rather than the traditional Pap test, is now the preferred primary screening method for those with a cervix between the ages of 25 and 65. HPV is the virus responsible for nearly all cervical cancer cases. Research shows that stand-alone HPV testing proves more powerful at identifying individuals who need follow-up care compared to a Pap test alone. However, screening with a Pap test, by itself or in combination with the HPV test (co-testing), remains a viable option within the new guidelines.
A groundbreaking addition is the new acceptance of Food and Drug Administration (FDA)-approved HPV self-collection kits. This allows women to collect their own sample at home or in a clinic. The self-collected test only screens for high-risk HPV variants, not for cellular changes. If a self-test returns a positive result, the patient must still follow up with a healthcare provider for a clinical exam and further testing. This new option attempts to address a major issue: access to healthcare. Allowing self-collection can remove barriers for women with limited access to clinical settings, improving overall screening rates.
Despite the benefits, some medical professionals express caution about the potential for patient error with self-administered tests. They stress the need for long-term data to confirm the self-collection method’s success rate compared to provider-collected samples.
Finally, the ACS provided more definitive criteria for when screening can safely stop. Individuals aged 65 and older can stop screening if they meet specific criteria for a history of normal results. Specifically, they must have consistently received regular screening and had either their last two HPV-inclusive tests or last three Pap tests come back normal. This new clarification helps reduce the risk of unnecessary over-screening in older adults while maintaining patient safety.
Regardless of the testing method or start age, health experts emphasize that the Pap test and HPV screening are only parts of comprehensive women’s health. All individuals should continue annual wellness visits, which include pelvic and breast exams, even if they are not due for cervical cancer screening. The overall goal is to improve adherence to all preventive care guidelines.
