Although infection with human papillomavirus, or HPV, is the leading cause of cervical cancer, until now, an influential government group has been reluctant to recommend using the HPV test to screen for the disease.
That changed on Wednesday when the U.S. Preventive Services Task Force (USPSTF) recommended that the HPV test is appropriate for some women as part of routine cervical cancer screening. The task force had previously said, in draft guidelines released in October, that there wasn’t enough evidence to recommend the HPV test, but the new recommendations are based on a review of the most recent scientific studies, which find that HPV tests can reliably detect cervical cancer and spare lives.
The group published its advice in the Annals of Internal Medicine this week. At the same time, the American Cancer Society and other groups released similar screening recommendations. In general, the new advice scales back the frequency of screening for cervical cancer — a slow-growing disease — in order to maximize its benefits for women, while reducing its risks. False-positive results can lead to unnecessary biopsies that may affect the health of pregnancy in the future, increasing women’s risks of preterm birth and low-birth-weight babies.
The USPSTF’s new screening guidelines advise:
- Women aged 21 to 65 should get Pap tests no more than every three years; previous guidelines, issued in 2003, recommended that women be screened “at least” every three years, allowing for annual screens
- Women aged 30 to 65 may extend the interval between screens to five years if they use HPV tests in conjunction with the Pap test; the HPV test should not be used in younger women because many of them will have HPV infection that they will naturally clear without treatment
- Women under 21 should not be screened for cervical cancer, regardless of sexual history; previous advice recommended that women begin cervical cancer screening within three years of becoming sexually active
- Women over 65 should not be screened, as long as they have had consistently normal Pap tests and are not at high risk for cervical cancer
The guidelines apply to healthy women who don’t have abnormal Pap tests. They do not apply to women who have a history of cervical cancer or other risk factors.
“The bottom line is, we strongly recommend screening,” Dr. Virginia Moyer, chair of the USPSTF and a pediatrician at Baylor College of Medicine and Texas Children’s Hospital, told Reuters. “The women who get and die of cervical cancer are the women who aren’t getting screened.”
Cervical cancer affects about 12,000 women in the U.S, each year, and kills about 4,200 annually.