New Cervical Cancer Screening Guidelines: HPV Testing & Self-Collection Options

New recommendations from the American Cancer Society (ACS) are changing the landscape of cervical cancer screening, with a greater emphasis on HPV testing and the acceptance of self-collected samples. These updated guidelines apply to individuals with a cervix who are at average risk and clarify when screening should begin and end.

Understanding the Changes

The ACS is one of two key organizations providing cervical cancer screening recommendations; the other is the United States Preventative Services Task Force (USPSTF). The USPSTF’s recommendations influence what health insurance plans will cover, and they are currently revising their own guidelines. The ACS now recommends “HPV primary” testing, which specifically looks for the types of human papillomavirus (HPV) known to cause almost all cases of cervical cancer.

If HPV primary testing isn’t available, the ACS suggests “co-testing,” which combines an HPV test with a Pap test (also known as cytology). If neither of these options are available, a Pap test alone is acceptable. A significant shift is the recommended starting age for screening, now set at 25, as cervical cancer is rare in younger people. This differs from current USPSTF recommendations.

Self-Collection: A New Option

Traditionally, samples for both HPV and Pap tests were collected by healthcare providers during a speculum exam. While provider collection remains the preferred method, the ACS acknowledges it can be difficult for some. Self-collected HPV tests are now considered an acceptable alternative. This could broaden access to screening for those without access to a gynecologist or who are uncomfortable with traditional exams.

Follow-up screening frequency depends on the test used and how the sample was collected. Those with normal results from HPV primary testing or co-testing with provider-collected samples should be screened again in five years. Those who self-collect and have normal results should be screened every three years, as should those who only receive a Pap test. Abnormal results will likely require more frequent screening.

The ACS recommends stopping screening at age 65 if a person has had ten years of normal results – either negative HPV tests at ages 60 and 65, or three consecutive negative Pap tests, with the last one at age 65.

The Importance of Screening

Nearly 14,000 cases of cervical cancer are diagnosed annually in the United States, resulting in over 4,000 deaths. However, cervical cancer typically grows slowly and can be detected and treated before it progresses. Screening is therefore crucial. More than half of cervical cancer diagnoses today occur in individuals who have never been screened or who are screened infrequently.

These new guidelines aim to improve screening compliance and reduce cervical cancer risk by offering more accessible options, including testing at primary care offices, urgent care clinics, mobile clinics, pharmacies, or through at-home self-collection.

Frequently Asked Questions

When should I start getting screened for cervical cancer?

The ACS recommends starting screening at age 25, regardless of the test used.

Can I collect my own sample for cervical cancer screening?

Yes, the ACS now accepts self-collected HPV tests as an alternative to samples collected by a healthcare provider.

How often will I need to be screened?

Screening frequency depends on the test used and how the sample was collected, ranging from every three to five years with normal results.

As screening options become more accessible, will more people take advantage of these preventative measures?