New Guidelines for Cervical Cancer Screening

　 USPSTF and ACS guidelines recommend less-frequent cytologic screening and the addition of HPV testing for most women.
     Cytologic screening for cervical cancer has markedly lowered the incidence of this disease. Improved understanding of the natural history of human papillomavirus (HPV) infection, along with recent trials that compared screening with cytology only versus cytology augmented with HPV testing, provides the basis for new screening guidelines by the American        

     Cancer Society ([ACS]; developed in collaboration with the American Society for Colposcopy and Cervical Pathology and the American Society for Clinical Pathology) and the U.S. Preventive Services Task Force (USPSTF).
     The table summarizes these new guidelines as well as the 2009 guidelines from the American College of Obstetricians and Gynecologists (JW Womens Health Nov 23 2009).
     Additional points are as follows:
• These recommendations do not apply to women who have immunosuppressive conditions (including HIV infection), who were exposed in utero to diethylstilbestrol, or who have had prior treatment for cervical intraepithelial neoplasia (CIN) 2+.
• The recommendations do apply to women who have been vaccinated against HPV because the HPV strains currently included in the vaccines account for only 70% of cervical cancers.
• The recommendations do not support HPV testing alone.
• Women who test positive for HPV need closer follow-up than HPV-negative women regardless of cytology results.

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