Recommendations for Cervical Cancer Screenings

The American College of Obstetrics & Gynecology (ACOG) encourages women to begin yearly cervical cancer screenings at age 21, and earlier for women who are younger than 21 and infected with HIV (human immunodeficiency virus).

The cervical cancer screening helps detect changes in the cells of the cervix that could lead to cancer. Screenings include cervical cytology (also called the Pap test or Pap smear) and, for some women, testing for human papillomavirus (HPV).

The recommendations address the ages and frequency at which women should be screened, as well as the type of tests they should have.

Cervical Cancer Risk Factors

The ACOG recommends more frequent cervical cancer screening for women with certain risk factors, such as:

• HIV infection.
• Compromised immune systems.
• Exposure in utero to diethylstilbestrol – commonly know as DES – a synthetic estrogen prescribed between 1938 and 1971 to pregnant women to prevent miscarriages or other pregnancy problems.
• Previous treatment for abnormal cervical tissue or cancer.

The ACOG recommendations followed a report in late 2014 by the U.S. Centers for Disease Control and Prevention (CDC) stating that an estimated eight million American women aged 21 to 65 years hadn’t been screened for cervical cancer in the past five years.

Cervical cancer remains one of the most highly preventable diseases in the U.S. It tends to occur in midlife and is most frequently diagnosed in women between the ages of 35 and 44, says the American Cancer Society.

Additional significant statistics reported in CDC findings include:

• Women who have never or rarely been screened represent more than 50 percent of new cervical cancer cases.
• Proper screening and getting the human papillomavirus (HPV) vaccine are among factors that can help prevent up to 93 percent of cervical cancers.
• HPV viruses cause the most cervical cancers.

Cervical Cancer Prevention

The ACS estimates that 2019 saw more than 13,000 new cases of cervical cancer and 4,250 deaths from the disease in the U.S. The number of cervical cancer cases and deaths from the disease have declined over the last several years.

Improvements in cervical cancer survival rates are mostly the result of increased screenings over the last 50 years. In 1975, there were 15 new cervical cancer cases per 100,000 women, compared to five per 100,000 women in 2012.

“The pap test has proven to be one of the single best cervical cancer screening methods developed to date,” said Nicholas Lambrou, M.D., chief of gynecologic oncology at Miami Cancer Institute. “While the disease most commonly affects women in their ‘30s and then later in life, proper screening continues to enable us to identify younger women – as early as in their ‘20s – with pre-cancer and invasive cervical cancer. The best way for women to prevent a cervical cancer diagnosis is to be consistent with annual visits to their gynecologist and receive the screenings that can save their lives. ”