The U.S. Preventive Services Task Force released draft recommendations outlining updated guidelines for cervical cancer screening, including replacing Pap testing with HPV testing after age 29.
Draft Recommendations
Key draft recommendations include screening women aged 21 to 29 years using a Pap test. Women aged 30 to 65 should be screened every 5 years with an HPV test or receive both tests every 5 years. This a grade A recommendation.
The Task Force recommends against screening women younger than 21, women over 65 who have had consistent normal test results, or women of any age who have had a total hysterectomy for non-cancer reasons. This is a grade D grade recommendation.
Self-Testing
For the first time, the Task Force has endorsed self-collected HPV testing, offering a private and convenient alternative to clinician-collected samples. Studies confirm this method is equally accurate and effective, particularly for underserved populations who may face barriers to traditional screening.
“We hope that this new, effective option helps even more women get
screened regularly,” stated Dr. Esa Davis, Task Force member.
According to the USPSTF, HPV testing every 5 years provides the best balance of benefits and potential harms for women aged 30 to 65, minimizing unnecessary follow-up tests and procedures while detecting cancer early. Dr. John Wong, vice chair of the Task Force, noted. The latest evidence highlights the value of HPV testing, but all three methods—HPV tests, Pap tests, and co-testing—are effective options for women.
Importance of Regular Screening
“Most cases of cervical cancer are in women who have not been regularly screened or appropriately treated after an abnormal test result,” explained Dr. Wanda Nicholson, chair of the Task Force. Routine screenings and the HPV vaccine have significantly reduced cervical cancer rates in the U.S., saving countless lives.
Women over 65 can discontinue screenings if they have a history of normal results from their last 3e Pap tests or last 2 HPV tests within the past decade, with 1 conducted in the past 5 years.
Applicability and Next Steps
These guidelines apply to cisgender women and individuals assigned female at birth, including transgender men and nonbinary individuals. However, they do not address women at increased risk, such as those with HIV or compromised immune systems.
The Task Force is seeking public comments on the draft recommendations from December 10, 2024, to January 13, 2025. To review the full recommendations and provide feedback, visit www.uspreventiveservicestaskforce.org.
